Delayed Gastrointestinal Bleeding from Traumatic Superior Mesenteric Artery Pseudoaneurysm

ABSTRACT

Acute onset of shock presented in a 23 years old male patient due to gastrointestinal bleeding. He had been in a car crash 49 days before presentation. On initial presentation, a small amount of intraperitoneal hemorrhage had been seen on a CT scan. An emergency selective superior mesenteric artery (SMA) arteriography revealed a pseudoaneurysm in the branch of SMA, but successive embolization of the terminal branch controlled the bleeding. It is hard to initially diagnose an aneurysm as the cause of spontaneous gastrointestinal bleeding in a patient that has suffered an abdominal trauma, so it poses a therapeutic challenge. Recognition of an aneurysm, and its early diagnosis based on the patient's past history, and its adoption as a judicious diagnostic tool are essential in the management of such patients.