Rare cause of fatal acute abdomen-celiac artery aneurysm

Aneurysm of the celiac artery is a rare type of visceral artery aneurysm with an incidence of 0.1 %2%, but it carries a definitive risk of rupture. Neurofibromatosis type 1 (NF-1) has a remarkable association with a spectrum of arterial diseases, including an occlusive or aneurismal disease. Less often it affects celiac arteries.

Here we present a case of rupture of celiac artery aneurysm in a patient NF-1 who presented with sudden onset of acute severe epigastric pain with tenderness and guarding in the epigastric region. Computed tomography (CT) scan revealed celiac artery aneurysm with evidence of retroperitoneal hematoma. As the patient became unstable, we performed emergency laparotomy in the best interest of the patient in our setting, and we barely controlled the source of bleeding. Unfortunately, we could not save the patient as he developed disseminated intravascular coagulation due to a massive blood transfusion.

Visceral artery aneurysm should be considered in patients present with an acute abdomen with anemia. As neurofibromatosis is associated with a spectrum of a vascular disease, vascular screening needs to be considered.

Even though celiac artery aneurysm is rare, it should be considered as one of the prompt differential diagnoses when patients present with an acute abdomen with anemia to prevent a fatal outcome.