title: Segmental arterial mediolysis of left gastric artery: a case report and review of pathology.
abstract: BACKGROUND
  Segmental arterial mediolysis (SAM) is a rare non inflammatory vascular disease that can present with massive haemorrhage, which may lead to death without prompt surgical intervention.
  
  
  METHODS
  A 60 years old Aboriginal female presented with life threatening, spontaneous intra-abdominal bleeding requiring an emergency laparotomy. The source of bleeding was found to be ruptured left gastric artery. A total gastrectomy was performed as a damage control procedure. A staged Roux-en-Y oesophago-jejunostomy with Hunt Lawrence pouch reconstruction was undertaken thirty six hours later. Histopathological findings revealed evidence of non-inflammatory segmental vascular damage with microaneurysm, consistent with segmental arterial mediolysis.
  
  
  CONCLUSIONS
  Prompt resuscitation and surgical intervention can decrease the morbidity and mortality in this rare clinical entity.
authors.forename: Azra
authors.initials: A
authors.lastname: Tabassum
authors.forename: Sanaz
authors.initials: S
authors.lastname: Sasani
authors.forename: Adeeb J
authors.initials: AJ
authors.lastname: Majid
authors.forename: Christopher
authors.initials: C
authors.lastname: Henderson
authors.affiliation: Department of Surgery, Liverpool Hospital, Liverpool, NSW 2170, Australia. n.merrett@uws.edu.au.
authors.forename: Neil D
authors.initials: ND
authors.lastname: Merrett