title: A diagnostic dilemma: acute abdomen presenting as segmental arterial mediolysis masked by a ruptured hepatocellular carcinoma.
abstract: A 65-year-old male was brought to our hospital with right upper abdominal fullness sensation and recent body weight loss of about 3 kg. The patient had developed episodes of melena following progressive abdominal muscular guarding and drop of haemoglobin level to 6.3 g/dL. An abdominal computed tomography scan disclosed a ruptured hepatocellular cell carcinoma. A segmental arterial mediolysis was found on the superior mesenteric artery in the process of repairing the ruptured right hepatic artery with the assistance of angiography. Transarterial embolization was carried out and permanent haemostasis was achieved.
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan ericliao0217@gmail.com.
authors.forename: Chen-Yi
authors.initials: CY
authors.lastname: Liao
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Wu-Hsien
authors.initials: WH
authors.lastname: Kuo
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: En-Hua
authors.initials: EH
authors.lastname: Huang
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: An-Tie
authors.initials: AT
authors.lastname: Hsieh
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Le
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Chi-Chang
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Hsueh
keywords: hepatocellular carcinoma; segmental arterial mediolysis