Segmental arterial mediolysis with a ruptured visceral artery on two consecutive days.

Autor: Ito C; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Koyama T; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Fujimori D; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Takahashi I; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Kasuya M; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Oe K; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Sakamoto S; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Yoshida R; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Yoshiike H; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Ito M; Department of Emergency Medicine Asahi General Hospital Chiba Japan., Yamashita W; Department of Radiology Asahi General Hospital Chiba Japan., Watanabe S; Department of Radiology Asahi General Hospital Chiba Japan., Isogai J; Department of Radiology Asahi General Hospital Chiba Japan.
Jazyk: angličtina
Zdroj: Acute medicine & surgery [Acute Med Surg] 2023 Oct 07; Vol. 10 (1), pp. e899. Date of Electronic Publication: 2023 Oct 07 (Print Publication: 2023).
DOI: 10.1002/ams2.899
Abstrakt: 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.
Competing Interests: The authors declare no conflict of interests for this article.
(© 2023 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine.)
Databáze: MEDLINE