Clin Exp Emerg Med.  2016 Jun;3(2):112-115. 10.15441/ceem.15.029.

Unusual presentation and treatment of isolated spontaneous gastric artery dissection

• Lim JY
• Choi YH
• Lee SH

• KMID: 2360987
• DOI: http://doi.org/10.15441/ceem.15.029

Abstract

Epigastric pain is a common symptom in the emergency department. Most epigastric pain is not fatal, except in acute myocardial infarction, aortic dissection, and abdominal aneurysm rupture. Epigastric pain can also be the only symptom of isolated spontaneous gastric artery dissection. We report the case of a 51-year-old woman diagnosed with neurofibromatosis who initially presented with only epigastric pain. She was initially misdiagnosed with gastritis, treated conservatively, and discharged. Two hours later, she returned to the emergency department with persistent epigastric pain and rebound tenderness in the epigastric area. Angiography revealed a left hepatic arterial aneurysm and right gastric artery dissection, which were subsequently embolized. Although extremely rare, patients presenting with epigastric pain at risk of vasculopathies should be considered for isolated spontaneous gastric artery dissection. Early recognition and definitive therapy lead to a favorable outcome.

Keyword

Aneurysm; Dissection; Hepatic artery

MeSH Terms

Aneurysm
Angiography
Arteries*
Emergency Service, Hospital
Female
Gastritis
Hepatic Artery
Humans
Middle Aged
Myocardial Infarction
Neurofibromatoses
Rupture