Background: Segmental arterial mediolysis (SAM) is a rare non inflammatory vascular disease that can present with massive haemorrhage, which may lead to death without prompt surgical intervention.
Case Presentation: A 60 years old Aboriginal female presented with life threatening, spontaneous intra-abdominal bleeding requiring an emergency laparotomy. The source of bleeding was found to be ruptured left gastric artery. A total gastrectomy was performed as a damage control procedure. A staged Roux-en-Y oesophago-jejunostomy with Hunt Lawrence pouch reconstruction was undertaken thirty six hours later. Histopathological findings revealed evidence of non-inflammatory segmental vascular damage with microaneurysm, consistent with segmental arterial mediolysis.
Conclusion: Prompt resuscitation and surgical intervention can decrease the morbidity and mortality in this rare clinical entity.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175101 | PMC |
| http://dx.doi.org/10.1186/1472-6890-13-26 | DOI Listing |
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