Sarigoz Talha, Carkit Sedat, Topuz Omer, Ertan Tamer, Koc Ali
Medical doctor and Attending Physician, General Surgery Clinic, Sason State Hospital, Batman, Turkey.
Medical doctor and Resident Physician, General Surgery Clinic, Kayseri Training and Research Hospital, Kayseri, Turkey.
Sao Paulo Med J. 2018 Sep-Oct;136(5):488-491. doi: 10.1590/1516-3180.2017.0070210417. Epub 2017 Aug 21.
Aneurysms of the gastroepiploic arteries are seen only rarely. They are usually diagnosed during autopsy or laparotomy in patients with hemodynamic instability. Although the operation to treat this condition is relatively easy, delay in making the diagnosis affects the course of the disease.
A 57-year-old woman was admitted to the emergency department with abdominal pain and unconsciousness. A computed tomography scan showed extravasation of contrast agent at the headcorpus junction of the pancreas, and the patient underwent exploratory laparotomy under general anesthesia. During laparotomy, aneurysmatic rupture of the right gastroepiploic artery was detected. Control over bleeding was achieved by ligating the right gastroepiploic artery at its origin. The aneurysm was also resected and sent for pathological examination.
Especially in cases of unidentified shock, splanchnic artery aneurysms should be kept in mind. Moreover, in the light of the data in the literature, the possibility of death should be taken into account seriously and, if feasible, prophylactic aneurysmectomy should be performed.
胃网膜动脉动脉瘤极为罕见。它们通常在尸检或剖腹手术中被诊断出来，患者多伴有血流动力学不稳定。尽管治疗这种疾病的手术相对简单，但诊断延迟会影响疾病进程。
一名57岁女性因腹痛和昏迷被紧急送往急诊科。计算机断层扫描显示胰腺头部体部交界处有造影剂外渗，患者在全身麻醉下接受了剖腹探查术。在剖腹手术中，发现右胃网膜动脉动脉瘤破裂。通过在其起源处结扎右胃网膜动脉实现了出血控制。动脉瘤也被切除并送去做病理检查。
特别是在不明原因休克的病例中，应考虑内脏动脉动脉瘤。此外，根据文献数据，应认真考虑死亡的可能性，可行时应进行预防性动脉瘤切除术。
