Nishimura Takeshi, Sakata Hiroyuki, Yamada Taihei, Osako Takaaki, Kohama Keisuke, Kako Yasukazu, Achiwa Sachiko, Furukawa Yoshitaka, Nakao Atsunori, Kotani Joji
Department of Emergency Disaster and Critical Care Medicine Hyogo Japan.
Department of Radiology Hyogo College of Medicine Hyogo Japan.
Acute Med Surg. 2015 May 12;3(1):39-42. doi: 10.1002/ams2.115. eCollection 2016 Jan.
We report a case of hemorrhagic shock due to a ruptured gastric artery aneurysm successfully treated with transarterial embolization. A 72-year-old woman with cholangitis presented with hemoperitoneum following a ruptured aneurysm of the gastric artery.
Emergent computed tomography and angiography were carried out and the patient was found to have spontaneous bleeding from both branches of the left and right gastric arteries. Transcatheter embolization was carried out at the distal branch of both gastric arteries with a coil. The patient recovered well with no recurrent bleeding.
Although rare, visceral artery rupture should be considered in the differential diagnosis of unexplained hemorrhagic shock with abrupt onset of hemoperitoneum. Computed tomography and angiography are useful tools for obtaining prompt and accurate localization of the bleeding points.
我们报告一例因胃动脉动脉瘤破裂导致出血性休克的病例，该病例通过经动脉栓塞成功治疗。一名患有胆管炎的72岁女性，在胃动脉动脉瘤破裂后出现腹腔积血。
进行了急诊计算机断层扫描和血管造影，发现患者左右胃动脉的两个分支均有自发性出血。用弹簧圈对胃动脉的两个分支的远端进行了经导管栓塞。患者恢复良好，无再次出血。
虽然罕见，但在鉴别诊断原因不明且突然发生腹腔积血的出血性休克时，应考虑内脏动脉破裂。计算机断层扫描和血管造影是快速准确确定出血点位置的有用工具。
