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Abstract
Spontaneous bleeding from a short gastric artery in the absence of pre-disposing trauma is reported very rarely. To the best of our knowledge, the published literature includes only 14 cases. Young men comprise almost all of the patients, and were induced by vomiting or gagging. The patients usually required emergent surgery. Our patient, a 32-year-old man, was diagnosed with spontaneous hemoperitoneum due to short gastric artery tearing after a few instances of vomiting. We managed him conservatively including fluid, vitamin K and antifibrinolytic agent without surgery.
References
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Fig. 1.
An abdominal CT with enhancement at admission (A-C) showed a small amount of fluid in the area of the gastrosplenic ligament. White arrow (B) indicates an enhanced linear structure in the arterial phase. It was considered an injured short gastric artery with contrast extravasation. A second CT was performed six days later (D-F), revealing that the amount of fluid collection in the lesser sac was decreased and there was no sign of active bleeding.
Fig. 3.
Change in (A) hemoglobin (Hb) levels, (B) mean arterial pressure (MAP) and pulse rate (PR) during conservative treatment without transfusion.
Table 1.
Literature review of spontaneous bleeding from a short gastric artery
| Author | Gender | Age (yr) | Predisposing symptom | Hypotension a | Treatment |
|---|---|---|---|---|---|
| Hayes et al.1 | Male | 21 | Vomiting | Present | Ligation of bleeder |
| Williams et al.2 | Male | 23 | Vomiting | Present | Ligation of bleeder |
| Kaplan and Hausmann3 | Male | 26 | Vomiting | Absent | Ligation of bleeder |
| Rodero et al.4 | Female | 26 | Vomiting | Absent | Ligation of bleeder |
| Sun5 | Male | 20 | Absent | Absent | Ligation of bleeder |
| Piccagliani et al.6 | Male | 25 | Vomiting | Absent | Ligation of bleeder |
| Byer and Witt7 | Male | 16 | Vomiting | Absent | Ligation of bleeder |
| Ho et al.8 | Male | 21 | Vomiting | Present | Ligation of bleeder |
| Jabr and Skeik9 | Male | 36 | Gag and nausea | Absent | Ligation of bleeder |
| García-García et al.10 | Male | 25 | Vomiting | Present | Ligation of bleeder |
| Rege and Bhat11 | Male | 14 | Vomiting | Absent | Ligation of bleeder, splenectomy |
| Faraj et al.12 | Male | 17 | Vomiting | Absent | Ligation of bleeder |
| Abbas13 | Male | 24 | Vomiting | Absent | Ligation of bleeder |
| Osunkunle and Al-Shoek14 | Male | 23 | Absent | Absent | Ligation of bleeder |
| Present case | Male | 32 | Vomiting | Absent | Conservative treatment |
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