Rupture of a jejunal artery aneurysm.
Aneurysm of the superior mesenteric artery or its branches is rare. We herein present a case of a ruptured aneurysm of the jejunal artery, a branch of the superior mesenteric artery, and we also review 19 cases of jejunal artery aneurysm reported in the English literature. A 66-year-old male who had received a fist blow to the face presented in the emergency ward of his local hospital. His physical examination was unremarkable and he went back home after treatment of his facial wound. Two hours later he again visited the hospital, this time for severe abdominal pain, and he was hospitalized for suspicion of an intraperitoneal hemorrhage. Selective arteriography of the superior mesenteric artery revealed a ruptured aneurysm in the first branch of the jejunal artery. An emergency laparotomy was performed, but the patient died 29h after the injury. Because there was no evidence of any trauma to the abdomen, we concluded that the cause of death was exsanguination due to a ruptured aneurysm, and was not directly related to the earlier trauma. This case is considered to be of medico-legal interest regarding whether the rupture resulted from a natural disease or was due to an assault.
Asano
Migiwa
M
Department of Legal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. asano@med.kobe-u.ac.jp
Nushida
Hideyuki
H
Nagasaki
Yasushi
Y
Tatsuno
Yoshitsugu
Y
Ueno
Yasuhiro
Y
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D017542:Aneurysm, Ruptured / Q000473:pathology*; D003287:Contrast Media; D017809:Fatal Outcome; D049429:Forensic Pathology; D006801:Humans; D007583:Jejunum / Q000098:blood supply* / Q000473:pathology; D008297:Male; D017538:Mesenteric Artery, Superior / Q000293:injuries* / Q000473:pathology*; D009102:Multiple Organ Failure / Q000209:etiology; D012769:Shock / Q000209:etiology; D014754:Violence
D003287:Contrast Media