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Case Reports
. 2018 Mar 13:2018:bcr2017223731.
doi: 10.1136/bcr-2017-223731.

Case of Segmental Arterial Mediolysis

Maneka M Britto  1 , Matthew Lukies  2 , Charles Milne  3 , Timothy Joseph  2 , James C Lee  1
Affiliations
Case Reports

Case of Segmental Arterial Mediolysis

Maneka M Britto et al. BMJ Case Rep. .

Abstract

Segmental arterial mediolysis (SAM) is a rare, non-inflammatory, vascular condition that predominantly affects medium-sized to large-sized abdominal arteries and can present with haemorrhage into the abdominal cavity. We report the case of a patient with SAM of the coeliac, splenic, renal and gastroduodenal arteries in whom endovascular coil embolisation was successfully used to treat a bleeding gastroduodenal artery pseudoaneurysm.

Keywords: general surgery; interventional radiology; vasculitis.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Axial CT abdominal angiogram (delayed phase) pre-procedure: 20 mm pseudoaneurysm of the gastroduodenal artery (white arrow) with surrounding haematoma. (B) Sagittal CT abdominal angiogram (arterial phase) pre-procedure: fusiform aneurysm and dissection flap of the coelic axis (white arrow).
Figure 2
Figure 2
(A) Catheter angiogram of the gastroduodenal artery via the coeliac axis: proximal and distal pseudoaneurysms of the gastroduodenal artery (smaller proximal pseudoaneurysm marked by white arrowhead; larger distal pseudoaneurysm marked by white arrow). (B) Catheter angiogram post-coil embolisation: no flow into the gastroduodenal pseudoanerysms (site of smaller proximal pseudoaneurysm marked by white arrowhead; site of larger distal pseudoaneurysm outlined by dotted white oval).
See this image and copyright information in PMC

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