title: Left gastric artery aneurysm rupture: a rare cause of retroperitoneal bleeding: a case report.
abstract: BACKGROUND
  Visceral artery aneurysms are very rare. Patients usually present as emergency secondary to the sudden rupture of the aneurysm or as an incidental finding on ultrasound, MRI or abdominal computed tomography. Among these, splenic artery aneurysms are the most common ones accounting for 60% of all splanchnic aneurysms and gastric and gastroepiploic aneurysms account for only about 4%.
  
  
  METHODS
  We present a 61-year-old Caucasian male previously fit and well, presenting with sudden onset epigastric pain due to retroperitoneal haemorrhage secondary to ruptured left gastric artery aneurysm. Apart from a tender epigastrium, there were no other obvious signs elicited on abdominal examination. He had persistent tachycardia and haemoglobin drop from 10 g/dl to 6.7 g/dl. He underwent a contrast computed tomography which identified the ruptured left gastric artery. The aneurysm was controlled successfully with coil embolisation of the left gastric artery. At three-month follow-up, there was no evidence of the aneurysm.
  
  
  CONCLUSIONS
  Clinical presentations that do not correlate with examination finding should prompt immediate extensive investigation. The aid of contrast computed tomography and minimally invasive radiological interventional is the key to a fruitful outcome for this very rare entity.
authors.affiliation: Core Surgical Trainee, Surgical Department, Queen Elizabeth Hospital, UK isao.nce@gmail.com.
authors.forename: Cho Ee
authors.initials: CE
authors.lastname: Ng
authors.affiliation: Senior Clinical Fellow, Surgical Department, Queen Elizabeth Hospital, UK.
authors.forename: Hazem
authors.initials: H
authors.lastname: Khout
authors.affiliation: Consultant Surgeon, Surgical Department, Queen Elizabeth Hospital, UK.
authors.forename: Rory
authors.initials: R
authors.lastname: Farrell
authors.affiliation: Consultant Surgeon, Surgical Department, Queen Elizabeth Hospital, UK.
authors.forename: Tarannum
authors.initials: T
authors.lastname: Fasih
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging* / Q000628:therapy; D000792:Angiography; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000379:methods; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging* / Q000628:therapy; D013270:Stomach / Q000098:blood supply*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: Left gastric artery aneurysm; coil embolisation; retroperitoneal bleeding