Upper Gastrointestinal Bleeding Due to a Left Gastric Artery Pseudoaneurysm: A Case Series

A Rare Case of a Gastric Ulcer Causing Left Gastric Artery Pseudoaneurysm

“…On an EGD, UGIB from LGA pseudoaneurysm should be suspected if a large Dieulafoy lesion-like structure or pulsating bulge is seen at the lesser curvature of the stomach. 12 This suspicion can be confirmed with a CTA or a digital subtraction angiography. Marilley et al 13 noted that endoscopic hemostasis should be avoided if LGA pseudoaneurysm is suspected because there is a high mortality rate of 12%–15% with its rupture.…”

“…All 26 patients' LGA pseudoaneurysms were found using either CTA or digital subtraction angiography. 12 UGIB due to LGA pseudoaneurysm should be suspected in patients presenting with hematochezia and/or melena with a history of gastric ulcer disease, chronic pancreatitis, cirrhosis, intra-abdominal malignancies, and/or surgeries. On an EGD, UGIB from LGA pseudoaneurysm should be suspected if a large Dieulafoy lesion-like structure or pulsating bulge is seen at the lesser curvature of the stomach.…”

Ultrasound-guided percutaneous coil and thrombin embolization of a left gastric artery pseudoaneurysm

“…Visceral pseudoaneurysms most commonly involve the splenic (60%), hepatic (20%), superior mesenteric (5.5%), celiac (4%), gastric and gastroepiploic (4%), intestinal (3%), pancreaticoduodenal and pancreatic (2%), and gastroduodenal (1.5%) arteries [3] . Ruptured or bleeding pseudoaneurysms have a reported mortality rate of 25%-70% [4] . Symptoms of visceral pseudoaneurysms include abdominal pain, nausea, vomiting, and gastrointestinal bleeding, though most patients are asymptomatic [5] .…”

“…Physical exam may reveal a painful, pulsatile mass, with bruit on auscultation of the pseudoaneurysm site [1] . Complications of pseudoaneurysms include ruptured or active bleeding which can lead to intra-abdominal hemorrhage, erosion and compression of adjacent structures, and hemosuccus pancreaticus [ 4 , 6 ]. Ruptured or bleeding pseudoaneurysms have a reported mortality rate of 25%-70% [4] .…”

“…Complications of pseudoaneurysms include ruptured or active bleeding which can lead to intra-abdominal hemorrhage, erosion and compression of adjacent structures, and hemosuccus pancreaticus [ 4 , 6 ]. Ruptured or bleeding pseudoaneurysms have a reported mortality rate of 25%-70% [4] . Transarterial embolization is the preferred method of treatment, but anatomic, equipment, and operator limitations can make this difficult to achieve [7] .…”