Published in:
Open Access 01-12-2013 | Case report
Segmental arterial mediolysis of left gastric artery: a case report and review of pathology
Published in: BMC Clinical Pathology | Issue 1/2013
Login to get accessAbstract
Background
Segmental arterial mediolysis (SAM) is a rare non inflammatory vascular disease that can present with massive haemorrhage, which may lead to death without prompt surgical intervention.
Case presentation
A 60 years old Aboriginal female presented with life threatening, spontaneous intra-abdominal bleeding requiring an emergency laparotomy. The source of bleeding was found to be ruptured left gastric artery. A total gastrectomy was performed as a damage control procedure. A staged Roux-en-Y oesophago-jejunostomy with Hunt Lawrence pouch reconstruction was undertaken thirty six hours later. Histopathological findings revealed evidence of non-inflammatory segmental vascular damage with microaneurysm, consistent with segmental arterial mediolysis.
Conclusion
Prompt resuscitation and surgical intervention can decrease the morbidity and mortality in this rare clinical entity.