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Published on: July 5, 2024
Segmental arterial mediolysis with a ruptured visceral artery on two consecutive days
Chikao Ito1, Tomohide Koyama1, Daisuke Fujimori1
1Department of Emergency Medicine Asahi General Hospital Chiba Japan.
Background:
We describe a case of segmental arterial mediolysis in which a vessel ruptured on two consecutive days.
Case Presentation:
A 69-year-old man presented with sudden-onset abdominal pain. Computed tomography showed a hematoma in the gastric wall. The patient was discharged after the pain was relieved but returned 8 h later with abdominal pain and shock. Repeated computed tomography revealed a massive intra-abdominal hemorrhage without previous aneurysm formation. Emergency angiography and coil embolization were successfully carried out. Segmental arterial mediolysis was diagnosed after irregular vasodilated lesions were observed in multiple arteries.
Conclusion:
This case suggests that accurately predicting the next vessel rupture is difficult. For patients experiencing intra-abdominal bleeding with segmental arterial mediolysis, we suggest treating only ruptured aneurysms and closely following-up unruptured aneurysms.
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