Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2014; 20(35): 12668-12672
Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12668
Ruptured gastric artery aneurysm: An uncommon manifestation of microscopic polyangiitis
Yoshihiro Ikura, Tomohiro Kadota, Shuhei Watanabe, Akira Arimoto, Eiko Nishioka
Yoshihiro Ikura, Department of Pathology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan
Tomohiro Kadota, Department of Gastroenterology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan
Shuhei Watanabe, Department of Nephrology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan
Akira Arimoto, Department of Surgery, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan
Eiko Nishioka, Department of Radiology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan
Author contributions: Ikura Y and Kadota T equally contributed to this work; Ikura Y and Kadota T designed the study, provided the discussion of the pathology, and wrote the manuscript; Kadota T, Watanabe S and Arimoto A collected the clinical data and provided the discussion of the clinical features; Nishioka E contributed to the interpretation of the radiological images.
Correspondence to: Yoshihiro Ikura, MD, Department of Pathology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan. ikura@takatsuki-hp.or.jp
Telephone: +81-72-6813801 Fax: +81-72-6823834
Received: February 19, 2014
Revised: May 6, 2014
Accepted: May 25, 2014
Published online: September 21, 2014
Processing time: 211 Days and 21.6 Hours
Abstract

Gastric artery aneurysm is a rare and lethal condition, and is caused by inflammatory or degenerative vasculopathies. We describe herein the clinical course of a patient with a ruptured gastric artery aneurysm associated with microscopic polyangiitis. Absence of vasculitic changes in the aneurysm resected and negative results of autoantibodies interfered with our diagnostic process. We should have adopted an interventional radiology and initiated steroid therapy promptly to rescue the patient.

Keywords: Aneurysm; Stomach; Microscopic polyangiitis; Segmental arterial mediolysis; Interventional radiology; Steroids; Therapy

Core tip: Gastric artery aneurysm is a rare and lethal condition. Segmental arterial mediolysis (SAM), one of major causes of the aneurysm, has been recognized to be distinguished from inflammatory arteriopathies because of a difference in therapeutic strategy. However, as the present case indicates, SAM may not be an independent disease entity but a morphological alteration associated with diverse vascular damages.