title: Gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery successfully treated with coil embolization: a case report and review of the literature.
abstract: Endoscopic hemostasis is a useful treatment modality for gastric ulcer bleeding. However, it is sometimes difficult to achieve hemostasis in cases with arterial bleeding, especially those complicated with vascular abnormalities. We describe a case with gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery. A 50-year-old female was admitted to our hospital with dizziness and tarry stools. Upper gastrointestinal endoscopy revealed bleeding from a gastric ulcer, and endoscopic hemostasis by endoscopic clipping was carried out. Computed tomography and abdominal angiography revealed the variant left gastric artery running below the gastric ulcer. In spite of endoscopic hemostasis and medication, re-bleeding from the gastric ulcer occurred.  A transcatheter coil embolization for the variant left gastric artery was performed and successfully achieved hemostasis. This case was accompanied by congenital absence of the splenic artery, which is an extremely rare condition. We herein describe this rare case and review previously reported cases.
authors.affiliation: Department of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Namikawa
authors.forename: Satoru
authors.initials: S
authors.lastname: Kakizaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takakusaki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Saito
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yata
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mori
mesh_terms: D004621:Embolization, Therapeutic; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016558:Hemostasis, Endoscopic; D006801:Humans; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D012008:Recurrence; D013157:Splenic Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013270:Stomach / Q000098:blood supply*; D013276:Stomach Ulcer / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications* / Q000175:diagnosis