Endovascular treatment of a ruptured aneurysm of the right gastric artery — case report

Abstract

Due to the increasing number of imaging studies performed by various medical specialties we observe a significant increase in the incidentally discovered visceral arterial aneurysms, most of which are asymptomatic. In this paper, we present a case of 71-year-old woman admitted to another hospital in a hemorrhagic shock and bleeding to the peritoneal cavity. After emergency laparotomy, which failed to find and control the source of bleeding, the patient was transferred to our institution. During CTA a bleeding visceral aneurysm was discovered. After previous unsuccessful open surgical attempt, we decided to try the endovascular approach first and were able to implant two stentgrafts into the proper hepatic artery via brachial approach successfully controlling the bleeding. In the postoperative period there were no signs of bleeding into the peritoneal cavity, and liver function remained unimpaired. The paper discusses the epidemiology, etiology, diagnosis and treatment of this rarely described acute condition. We were also able to demonstrate the long-term durability of the emergency procedure with a 6-year follow-up showing patency of the hepatic artery without any signs of restenosis despite the use of previous generation stentgrafts.