Spontaneous rupture of a pseudoaneurysm of the left gastric artery presenting as a non-specific abdominal pain: a case report
Introduction: Pseudoaneurysms are false aneurysm caused by a hematoma that forms outside the arterial wall and continues to communicate with the artery. It is usually cased by vascular injury from trauma or pancreatitis.
Presentation of Case : A 59-year old female presented with severe acute periumbilical pain radiating to the left flank. Physical examination showed tenderness at RLQ and hypogastric area with guarding. CT Scan revealed long segmental circumferential wall thickening of the distal jejenum with moderate ascites. Tachycardia and decreasing hemoglobin prompted further investigation through mesenteric angiogram which revealed a pseudoaneurysm at the left gastric artery. Embolization was done and the patient’s status improved.
Discussion: Pseudoaneurysms of visceral arteries are uncommon and are attributed to degeneration of the vessel wall mostly due to infection, adjacent inflammation such as pancreatitis, trauma, and iatrogenic causes. Hemorrhage due to rupture of these pseudoaneurysms is a rare but often life threatening. Endovascular management is both diagnostic and therapeutic for pseudoaneurysms.
Conclusion: Visceral pseudoaneurysm is caused by pancreatitis or splanchnic trauma. Endovascular management is safe and effective in diagnosing and treating visceral pseudoaneurysms.