Open Access Case report

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

Azra Tabassum1, Sanaz Sasani2, Adeeb J Majid1, Christopher Henderson23 and Neil D Merrett13*

Author Affiliations

1 Department of Surgery, Liverpool Hospital, Liverpool, NSW 2170, Australia

2 Department of Anatomical Pathology, South Western Area Pathology Service, Liverpool Hospital, Liverpool, NSW 2170, Australia

3 School of Medicine, University of Western Sydney, Sydney, NSW, Australia

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BMC Clinical Pathology 2013, 13:26  doi:10.1186/1472-6890-13-26

Published: 29 October 2013



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.


Prompt resuscitation and surgical intervention can decrease the morbidity and mortality in this rare clinical entity.

Segmental arterial mediolysis; Haemorrhage; Pathology; Aneurysm; Vasculitis