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BMJ Case Reports 2013; doi:10.1136/bcr-2013-008772
  • CASE REPORT

Ruptured jejunal artery aneurysm

  1. Jorge Maciel
  1. Department of Surgery and Department of Radiology, Centro Hospitalar Gaia/Espinho, EPE, Gaia, Portugal
  1. Correspondence to Dr Sílvia Costa, sisse.costa{at}gmail.com

Summary

Visceral artery aneurysms (VAAs), unlike aortic aneurysms, are very rare, but are also a potentially lethal vascular disease. Jejunal artery aneurysms only account for less than 3% of VAAs, but have a 30% risk of rupture, with 20% death rate, presenting with only few and vague symptoms. We report the case of a 76-year-old man presenting at the emergency department (ED) with a crampy epigastric pain and vomiting. An ultrasound performed diagnosed free abdominal fluid and immediate CT scan diagnosed jejunal artery aneurysm spontaneously rupturing, followed by hypovolaemic shock. Emergent surgery was undertaken, and aneurysmectomy, followed by partial enterectomy with primary anastomosis were performed, because of segmentary jejunal ischaemia. The patient's recovery was unremarkable. High level of suspicion, rapid diagnosis capability and prompt surgical or endovascular intervention, as well as an effective teamwork in the ED are critical to avoid the devastating consequences of ruptured VAAs.

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