Gastric bleeding in giant cell arteritis

Giant cell arteritis (GCA) is a systemic vasculitis that classically affects large- and medium-sized vessels in the head and neck but can also manifest extracranially. We report the case of an elderly man who presented with sharp substernal pain, dizziness, and visual changes. He was initially hypotensive and anemic, and imaging showed hemoperitoneum with possible extravasation. Celiac and gastric angiography demonstrated findings consistent with vasculitis and focal extravasation from a left gastric branch. Subsequent embolization was performed. After the procedure, the patient informed the care team that he had biopsy-proven GCA. Extracranial, celiac/mesenteric arteriopathy is a less common manifestation of GCA, and few reported cases include hemoperitoneum or involvement of second-order branches.