A gastric artery aneurysm complicated by a dissection of gastric and hepatic arteries: possible role of adventitial inflammation and disruption of internal elastic lamina in splanchnic artery dissection.
A 77-year-old woman was found deceased at home. An autopsy examination revealed a hemoperitoneum due to a ruptured false aneurysm of a branch of the left gastric artery. A long dissection extending from the aneurysm involved splanchnic arteries including the left gastric, common hepatic, right and left branches of proper hepatic, and intrahepatic arteries. An intimal tear was identified in the common hepatic artery. Neutrophils infiltrating in the adventitia may have been reactive and may have triggered the adventitial rupture of aneurysm or development of the dissection. Disruption of the internal elastic lamina, which has been proposed to cause dissection of intracranial arteries, was seen in the dissected arteries. Little is currently known about aneurysms or dissections of splanchnic arteries; however, observation of adventitial inflammation and internal elastic lamina may help disclose the etiology and pathogenesis.
Department of Pathology, Ball Memorial Hospital, Muncie, IN, USA. mkobayashi@chsmail.org
Masahiko
M
Kobayashi
Paul F
PF
Mellen
D000368:Aged; D000784:Aortic Dissection / Q000473:pathology*; D017541:Aneurysm, False / Q000473:pathology*; D017542:Aneurysm, Ruptured / Q000473:pathology*; D002481:Cellulitis / Q000473:pathology; D004547:Elastic Tissue / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D006499:Hepatic Artery / Q000293:injuries* / Q000473:pathology; D006801:Humans; D009504:Neutrophils / Q000473:pathology; D013152:Splanchnic Circulation; D013270:Stomach / Q000098:blood supply*; D017539:Tunica Intima / Q000293:injuries / Q000473:pathology; D017540:Tunica Media / Q000473:pathology