A Case of Ruptured Aneurysm of the Left Gastric Artery with Early Gastric Cancer

Tsutomu Kaetsu, Kazushige Arai, Takashi Harada, Yoshibumi Maruoka, Satoshi Suzuki, Hiroshi Ishii, Sadaaki Kato, Masatoshi Kawamura, Tadashi Koike, Yusuke Shikama*, Kejnji Matsumura*

Department of Surgery, Showa University School of Medicine
*First Department of Internal Medicine, Showa University School of Medicine

A 70-year-old man was admitted to our hospital with the complaint of speech and dysarthric disturbance. He had a hematoma in the left lobe of the his brain. During conservative therapy, he had a sudden bleeding shock. Endoscopic examination showed a type IIc, early gastric cancer at the upper body of the stomach, but there was no evidence of bleeding. Abdominal CT and ultrasonography revealed an intra-abdominal hematoma under the liver, so abdominal angiography was performed. The findings revealed aneurysms of the left gastric artery. Total gastrectomy was performed under the diagnosis of a ruptured aneurysm of the left gastric artery with early gastric cancer and he recovered. Ten cases of this rare disease have been reported in the Japanese literature. In six patients, the aneurysms ruptured, and they were treated appropriately and recovered. As shown in these cases, the outcome of a ruptured aneurysm has improved recently, however, it is still difficult to diagnose. If you see a patient with abdominal pain of unknown origin and sudden shock, you should consider an aneurysm of the gastric artery.

Key words
aneurysm of gastric artery, ruptured aneurysm, early gastric cancer

Reprint requests
Tsutomu Kaetsu Department of Surgery, Showa University School of Medicine
1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142 JAPAN

Accepted
October 11, 1990

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