Korean J Gastroenterol.  2016 Sep;68(3):152-155. 10.4166/kjg.2016.68.3.152.

Spontaneous Bleeding from a Short Gastric Artery after Vomiting Successfully Treated without Surgery

• Hong SW
• Chang YG
• Lee B
• Lee WY

• KMID: 2358718
• DOI: http://doi.org/10.4166/kjg.2016.68.3.152

Abstract

Spontaneous bleeding from a short gastric artery in the absence of pre-disposing trauma is reported very rarely. To the best of our knowledge, the published literature includes only 14 cases. Young men comprise almost all of the patients, and were induced by vomiting or gagging. The patients usually required emergent surgery. Our patient, a 32-year-old man, was diagnosed with spontaneous hemoperitoneum due to short gastric artery tearing after a few instances of vomiting. We managed him conservatively including fluid, vitamin K and antifibrinolytic agent without surgery.

Keyword

Hemoperitoneum; Splenic artery; Vomiting

MeSH Terms

Adult
Arteries*
Gagging
Hemoperitoneum
Hemorrhage*
Humans
Male
Splenic Artery
Tears
Vitamin K
Vomiting*
Vitamin K

Figure

• 

  Fig. 1. An abdominal CT with enhancement at admission (A-C) showed a small amount of fluid in the area of the gastrosplenic ligament. White arrow (B) indicates an enhanced linear structure in the arterial phase. It was considered an injured short gastric artery with contrast extravasation. A second CT was performed six days later (D-F), revealing that the amount of fluid collection in the lesser sac was decreased and there was no sign of active bleeding.

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  Fig. 2. Schematic of the bleeding point and vascular structures around the stomach.

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  Fig. 3. Change in (A) hemoglobin (Hb) levels, (B) mean arterial pressure (MAP) and pulse rate (PR) during conservative treatment without transfusion.

Reference

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