Segmental arterial mediolysis of left gastric artery : a case report and review of patholgy

Azra Tabassum; Sanaz Sasani; Adeeb J. Majid; Christopher Henderson; Neil D. Merrett

doi:10.1186/1472-6890-13-26

Segmental arterial mediolysis of left gastric artery : a case report and review of patholgy

Azra Tabassum, Sanaz Sasani, Adeeb J. Majid, Christopher Henderson, Neil D. Merrett

School of Medicine

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

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.

Original language	English
Article number	26
Number of pages	5
Journal	BMC Clinical Pathology
Volume	13
Issue number	1
DOIs	https://doi.org/10.1186/1472-6890-13-26
Publication status	Published - 2013

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© 2013 Tabassum et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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abstract = "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.",

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AU - Merrett, Neil D.

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N2 - 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.

AB - 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.

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Segmental arterial mediolysis of left gastric artery : a case report and review of patholgy

Abstract

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