CASE REPORT

Gastric Ulcer Bleeding from a Variant Left Gastric Artery Accompanied by Congenital Absence of the Splenic Artery Successfully Treated With Coil Embolization: a Case Report and Review of the Literature

download Full Article (PDF file)

Masashi Namikawa^1,2,3, Satoru Kakizaki ³*, Satoshi Takakusaki¹, Shuichi Saito¹, Yutaka Yata², Masatomo Mori³

1) Department of Internal Medicine, Kiryu Kosei General Hospital, Kiryu;
2) Department of Gastroenterology and Hepatology, Saiseikai Maebashi Hospital, Maebashi;
3) Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

Abstract

Endoscopic hemostasis is a useful treatment modality for gastric ulcer bleeding. However, it is sometimes difficult to achieve hemostasis in cases with arterial bleeding, especially  those complicated with vascular abnormalities. We describe a case with gastric ulcer bleeding from a variant left gastric artery accompanied by congenital absence of the splenic artery. A 50-year-old female was admitted to our hospital with dizziness and tarry stools. Upper gastrointestinal endoscopy revealed bleeding from a gastric ulcer, and endoscopic hemostasis by endoscopic clipping was carried out. Computed tomography and abdominal angiography revealed the variant left gastric artery running below the gastric ulcer. In spite of endoscopic hemostasis and medication, re-bleeding from the gastric ulcer occurred.  A transcatheter coil embolization for the variant left gastric artery was performed and successfully achieved hemostasis. This case was accompanied by congenital absence of the splenic artery, which is an extremely rare condition. We herein describe this rare case and review previously reported cases.

Key words
Gastric ulcer bleeding - interventional radiology - coil embolization - congenital absence of the splenic artery.