Jornal Vascular Brasileiro
http://www.jvb.periodikos.com.br/article/doi/10.1590/1677-5449.202502172
Jornal Vascular Brasileiro
Case Report

Ruptured left gastric artery aneurysm presenting with life-threatening intraperitoneal hemorrhage: a rare vascular emergency

Ruptura de aneurisma da artéria gástrica esquerda apresentando-se com hemorragia intraperitoneal com risco de vida: uma emergência vascular rara

Ayman Hassan Khamis Alserr; Mohammad Salem Amer; Malak Mohsin Almarhoun; Mansoor Cherumkuzhiyil Abdulla

http://dx.doi.org/10.1590/1677-5449.202502172 J Vasc Bras, vol.25, e20250217, 2026
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Abstract

Visceral artery aneurysms are rare, with left gastric artery aneurysms representing a small proportion. Most are asymptomatic and incidentally detected, but rupture can lead to life-threatening intra-abdominal hemorrhage. We report a 50-year-old male presenting with sudden epigastric pain and hypovolemic shock. Imaging revealed a ruptured left gastric artery aneurysm with active bleeding and extensive hemoperitoneum. Emergency laparotomy with aneurysm excision and vessel ligation was performed successfully. The patient’s postoperative course was uneventful, and follow-up imaging showed no residual aneurysm. This case underscores the need for early recognition and prompt surgical intervention to improve outcomes in this rare condition.

Keywords

gastric artery aneurysm; intraperitoneal hemorrhage; vascular emergency

Resumo

Aneurismas de artérias viscerais são raros, sendo os da artéria gástrica esquerda uma pequena parcela desses casos. A maioria é assintomática e detectada incidentalmente, mas a ruptura pode levar a hemorragia intra-abdominal com risco de vida. Relatamos o caso de um homem de 50 anos que apresentou dor epigástrica súbita e choque hipovolêmico. Os exames de imagem revelaram ruptura de aneurisma da artéria gástrica esquerda com sangramento ativo e hemoperitônio extenso. Foi realizada laparotomia de emergência com ressecção do aneurisma e ligadura do vaso com sucesso. O pós-operatório do paciente transcorreu sem intercorrências e os exames de imagem de acompanhamento não demonstraram aneurisma residual. Este caso ressalta a necessidade de reconhecimento precoce e intervenção cirúrgica imediata para melhorar os desfechos nessa condição rara.

Palavras-chave

aneurisma da artéria gástrica; hemorragia intraperitoneal; emergência vascular

References

1 Monteagudo-Vela V, Duran J, Sebastián V, et al. Ruptured left gastric artery aneurysms: three cases managed successfully with open surgical repair. J Vasc Surg. 2016;64(3):e1-4.

2 Barrionuevo P, Malas MB, Nejim B, et al. A systematic review and meta-analysis of the management of visceral artery aneurysms. J Vasc Surg. 2019;70(5):1694-9. https://doi.org/10.1016/j.jvs.2019.02.024. PMid:31126761.

3 Juntermanns B, Bernheim J, Hoffmann JN, et al. Visceral artery aneurysms. Gefasschirurgie. 2018;23(S1 Suppl 1):19-22. https://doi.org/10.1007/s00772-018-0384-x. PMid:29950792.

4 Çakmak P. Left gastric artery aneurysm rupture: case report and review. J Emerg Med Case Rep. 2018;9(4):68-70. https://doi.org/10.5152/jemcr.2018.2211.

5 Barrionuevo P, Malas MB, Nejim B, et al. A systematic review and meta-analysis of the management of visceral artery aneurysms. J Vasc Surg. 2019;70(5):1694-9. https://doi.org/10.1016/j.jvs.2019.02.024. PMid:31126761.

6 Çakmak P. Left gastric artery aneurysm rupture: case report. J Emerg Med Case Rep. 2018;9(4):68-70. https://doi.org/10.5152/jemcr.2018.2211.

7 Monteagudo-Vela V, Duran J, Sebastián V, et al. Ruptured left gastric artery aneurysms: three cases managed successfully with open surgical repair. J Vasc Surg. 2016;64(3):e1-4.

8 Koelemay MJ, Iborra E, Malan A, et al. European Society for Vascular Surgery (ESVS) 2025 clinical practice guidelines on the management of diseases of the mesenteric and renal arteries and veins. Eur J Vasc Endovasc Surg. 2025;70(2):153-5. https://doi.org/10.1016/j.ejvs.2025.06.010. PMid:40513642.

9 Tipaldi MA, Krokidis M, Orgera G, et al. Endovascular management of giant visceral aneurysms. Sci Rep. 2021;11(1):700. https://doi.org/10.1038/s41598-020-80150-2. PMid:33436829.

10 Chaer RA, Abularrage CJ, Coleman DM, et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020;72(1S):3S-9S. https://doi.org/10.1016/j.jvs.2020.01.039. PMid:32201007.

11 Cohnert T, Collet JP, Czerny M. 2017 ESC Guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. https://doi.org/10.1093/eurheartj/ehx095. PMid:28886620.
 

Submitted date:
01/10/2026

Accepted date:
07/01/2026

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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