Ikura Y, Kadota T, Watanabe S, Arimoto A, Nishioka E. Ruptured gastric artery aneurysm: An uncommon manifestation of microscopic polyangiitis. World J Gastroenterol 2014; 20(35): 12668-12672 [PMID: 25253973 DOI: 10.3748/wjg.v20.i35.12668]
Corresponding Author of This Article
Yoshihiro Ikura, MD, Department of Pathology, Takatsuki General Hospital, 1-3-13, Kosobecho, Takatsuki 569-1192, Japan. ikura@takatsuki-hp.or.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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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.
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.
