Segmental arterial mediolysis of left gastric artery: a case report and review of pathology
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
BMC Clinical Pathology 2013, 13:26 doi:10.1186/1472-6890-13-26Published: 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.
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.