Vomiting-induced short gastric artery apoplexy

Abstract

Abdominal apoplexy due to short gastric artery rupture following vomiting is an exceedingly rare condition. It results from non-traumatic and non-iatrogenic causes. This entity has variable clinical presentation and patients usually present with non-specific abdominal pain. Imaging plays a vital role in early diagnosis, as immediate exploratory laparotomy is the treatment of choice for successful outcome and helps to reduce mortality rate. We report the case of a 27-year-old male patient who presented to the emergency department with acute-onset abdominal pain after multiple episodes of vomiting following binge alcohol drinking. Contrast-enhanced CT revealed intraperitoneal haemorrhage secondary to vessel rupture, probably from a short gastric artery. Intraoperatively, the short gastric artery was identified as the bleeding source and ligated. The patient had an uneventful postoperative course.

Point‐of‐care ultrasound‐assisted diagnosis of gastric vessel rupture in a young man presenting with chest pain: A cautionary tale

“…9 In prior case reports, patients with rupture of the gastric vessels typically present with abdominal pain after vomiting or gagging and haemodynamic instability, which were absent in this case. 10,11 In all of these cases, the diagnosis was made on a CT scan of the abdomen with contrast, 12 with the majority occurring as a result of the rupture of left gastric vessels, including short gastric, gastroepiploic or splenic arteries. 13 It is a condition that typically requires surgical intervention or an endovascular procedure to achieve haemostasis, with a good prognosis with timely intervention.…”

Abdominal apoplexy: rupture of short gastric artery after retching

“…In our patient, the only obvious predisposing factor was the protracted retching and multiple episodes of vomiting. Although the act of emesis is commonly associated with Mallory-Weis tear, gastrointestinal bleeding, or disruption in the continuity of the esophagus, cardio-esophageal junction, or the stomach, literature search suggests that it can also cause rupture of the short gastric artery (5,6). Retching may cause partial volvulus and pull the gastrosplenic ligament, causing a shearing force that results in a tear of the short gastric artery (7).…”