Ruptured Left Gastric Artery Aneurysm Successfully Treated by Thrombin Injection: Case Report and Literature Review

Chandran, S; Parvaiz, Amjad; Karim, Aftab; Ghafoor, I; Steadman, Brent T.; Pearce, Neil; Primrose, John

doi:10.1100/tsw.2005.8

Cited by 19 publications

(22 citation statements)

References 5 publications

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“…Aneurysms of the LGA are rare and account for less than 4% of all visceral artery aneurysms. [1][2][3][4] Many patients are asymptomatic (discovered incidentally, particularly due to the greater utilisation of imaging) or minimally symptomatic. 3,5 These aneurysms or pseudoaneurysms are often secondary to inflammation (peptic ulcer disease, pancreatitis) or infection (mycotic processes), with resultant periarterial inflammation or degeneration of the media.…”

Section: Discussionmentioning

confidence: 99%

“…3,5 These aneurysms or pseudoaneurysms are often secondary to inflammation (peptic ulcer disease, pancreatitis) or infection (mycotic processes), with resultant periarterial inflammation or degeneration of the media. 1,2 Trauma and vasculitis are other causes. 5 Given the history of H. pylori infection, our patient likely had a pseudoaneurysm of the LGA.…”

Section: Discussionmentioning

confidence: 99%

“…2 Intramural lesions are more common (70%) and present with haematemesis when they rupture into the gastric lumen, whilst when extramural (30%) they result in intraperitoneal haemorrhage; mortality can be as high as 70% to 80%, so early treatment is advocated to prevent such complications. 1,2 Surgery was previously the standard of care. In LGA aneurysms have been successfully treated endovascularly with microcoils, 1 glue as well as ethylene vinyl alcohol copolymer (Onyx).…”

Section: Discussionmentioning

confidence: 99%

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Embolisation of a Left Gastric Artery Pseudoaneurysm by Transcatheter Thrombin Injection Guided by Fluoroscopy and Doppler Ultrasound

Tan¹,

H'ng²,

O’Donnell³

et al. 2014

Hong Kong J Radiol

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We present a case with a left gastric artery pseudoaneurysm in a 51-year-old female confirmed on computed tomography and angiography. These aneurysms are rare but are prone to rupture leading to death. Although many are discovered incidentally, early definitive treatment is advocated to prevent subsequent rupture. Successful embolisation was achieved by transcatheter intra-arterial thrombin injection guided by fluoroscopic and Doppler ultrasound imaging. Our case demonstrates an alternative way of treating these entities by recourse to interventional radiology.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Embolisation of a Left Gastric Artery Pseudoaneurysm by Transcatheter Thrombin Injection Guided by Fluoroscopy and Doppler Ultrasound

Tan¹,

H'ng²,

O’Donnell³

et al. 2014

Hong Kong J Radiol

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“…However, aneurysms of the pancreaticoduodenal and gastroduodenal arteries have also presented with hematemesis or hemobilia secondary to localized erosion into neighbouring structures, as well as obstructive jaundice (10,12). Mortality after rupture of these aneurysms has been reported to be as high as 70%, so the traditional standard has been to repair these aneurysms when they are identified (13).…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic shock secondary to rupture of a right gastroepiploic artery aneurysm: Case report and brief review of splanchnic artery aneurysms

Faler¹,

Mukherjee²

2007

Int J Angiol

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A case of a 78-year-old woman who presented with hemorrhagic shock and abdominal pain, and who was subsequently found to have a ruptured aneurysm of the right gastroepiploic artery, is presented. She underwent open surgical resection of the aneurysm without any significant postoperative complication. A brief review of splanchnic artery aneurysms with regard to their incidence, presentation and approaches for repair is also presented.Key Words: Gastroepiploic artery; Splanchnic aneurysm CASE PRESENTATIONA case of a 78-year-old woman who was transported to the emergency room with mental status deterioration associated with hypotension and abdominal pain is presented. Her medical history was significant for hypertension, atrial fibrillation, dementia and a previous aortic valve replacement. She was being anticoagulated with coumadin for both her valve replacement and her atrial fibrillation. Physical examination showed the patient to have a pulse rate of 110 beats/min, blood pressure of 80/40 mmHg and normal temperature. She was alert, but lethargic and confused. Her abdominal examination showed a nondistended abdomen with diffuse tenderness. She did not have melenic stool or bright red blood per rectum, and there was no history of nausea or hematemesis. Laboratory evaluations were significant for hemoglobin of 7 g/L, a hematocrit of 22%, white blood cell count of 8×10 9 /L, and normal blood urea nitrogen and creatinine. Resuscitation measures were instituted, and the patient underwent a computed tomography scan of the abdomen and pelvis with oral and intravenous contrast (Figure 1). The images demonstrated a large (5.2 cm) ruptured aneurysm extending off the right greater curvature of the stomach with moderate hemoperitoneum. The patient was then taken to the operating room for an exploratory celiotomy. Approximately 2 L of blood were aspirated from the peritoneal cavity upon entry. The source of bleeding was found to be a ruptured aneurysm of the right gastroepiploic artery (GEA). The aneurysm was then resected following proximal and distal arterial control. Upon completion, the patient was noted to have a tear on the medial surface of the spleen with subsequent mild bleeding. Due to the need for postoperative anticoagulation for the patient's prosthetic valve, it was decided to perform a splenectomy. The patient was transferred to the surgical intensive care unit where she remained intubated for three days. She was transferred to the ward where she recovered without any postoperative complications until the time of discharge to a rehabilitation facility. A repeat computed tomography scan was performed ( Figure 1D) for a leukocytosis that showed complete resection of the aneurysm and no other pathology.

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“…GEAA rupture is associated with a high mortality rate [2]. Few cases of ruptured GEAAs have been reported, and most of those patients were treated by open surgery.…”

Section: Introductionmentioning

confidence: 99%

Successful transcatheter arterial embolization of a ruptured right gastroepiploic artery aneurysm: A case report

Ishimine

Tengan

Nakasu

et al. 2018

International Journal of Surgery Case Reports

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Ruptured Left Gastric Artery Aneurysm Successfully Treated by Thrombin Injection: Case Report and Literature Review

Cited by 19 publications

References 5 publications

Embolisation of a Left Gastric Artery Pseudoaneurysm by Transcatheter Thrombin Injection Guided by Fluoroscopy and Doppler Ultrasound

Embolisation of a Left Gastric Artery Pseudoaneurysm by Transcatheter Thrombin Injection Guided by Fluoroscopy and Doppler Ultrasound

Hemorrhagic shock secondary to rupture of a right gastroepiploic artery aneurysm: Case report and brief review of splanchnic artery aneurysms

Successful transcatheter arterial embolization of a ruptured right gastroepiploic artery aneurysm: A case report

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