Korean J Helicobacter Up Gastrointest Res.  2021 Sep;21(3):235-238. 10.7704/kjhugr.2021.0022.

Spontaneous Rupture of the Right Gastroepiploic Artery Immediately after Gastroscopy

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
  • 2Department of Radiology and Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, Korea

Abstract

Idiopathic spontaneous intraperitoneal hemorrhage is both rare and potentially fatal. The incidence of gastroepiploic artery rupture, especially a non-aneurysmal rupture, is extremely low. We report the case of an elderly woman who was mistakenly diagnosed with procedure-related bleeding after gastroscopy. A 0.3 cm polyp was identified and removed during the procedure. The patient later developed shock due to which gastroscopy was repeated; however, no unusual findings were observed. Therefore, abdominopelvic computerized tomography was performed and gastroepiploic artery rupture was detected. Transcatheter arterial embolization was immediately performed without laparotomy, without any complications. The bleeding was controlled, and the patient was discharged after embolization. It is important to acknowledge the possibility of spontaneous rupture of the visceral arteries in elderly individuals with hypertension or atherosclerosis, especially in the event of sudden abdominal pain or shock immediately after an endoscopic procedure. This is the first case report of idiopathic spontaneous rupture of the right gastroepiploic artery successfully managed by transcatheter arterial embolization in South Korea.

Keyword

Gastroepiploic artery; Gastroscopy; Rupture; Spontaneous
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