Ruptured left colic arterial aneurysm treated by transcatheter arterial embolization alone and without a subsequent laparotomy: Report of a case

Abstract

We herein report the case of a 49-year-old male patient with a ruptured aneurysm originating in the left colic artery, which was successfully treated by transcatheter arterial embolization (TAE) Abdominal computed tomography revealed a large hematoma with a central small aneurysm in the left upper abdomen. Celiac and superior mesenteric arteriography showed no dye extravasation. Subsequent aortography showed an aneurysm arising from the branch of the left colic artery that was successfully treated by selective TAE. Further surgery for subsequent ischemia was not performed. In cases presenting with an unclear source of intraabdominal bleeding, an aneurysm of the inferior mesenteric arterial branch should be considered. Transcatheter arterial embolization is a plausible initial treatment option as an effective therapeutic approach because it provides a curative and less invasive alternative to other therapies. Based on our experience and a review of the literature, surgery may not necessarily be imperative, even in cases of a ruptured aneurysm of a colic arterial branch after TAE.

Current management strategies for visceral artery aneurysms: an overview

“…Jejunal, ileal, and colic artery aneurysms rarely occur and account for 3-6% of all VAAs [5,7,12]. Most reported lesions are solitary and smaller than other VAAs, being about 10 mm in diameter [78,79]. Among mesenteric branch artery aneurysms, colic artery rupture is commonly reported, and the mortality rate associated with ruptures is 20% [16].…”

“…Thus, even if asymptomatic, treatment is recommended regardless of aneurysm size [78]. Although the most common therapeutic strategy is open surgery, there is a report stating that EVT was effective for rupture [79].…”