Ruptured ileal artery pseudoaneurysm: a rare cause of lower gastrointestinal hemorrhage

Abstract

Introduction. Pseudoaneurysms of superior mesenteric artery and its branches are extremely rare but life threatening when complications occur. However, the diagnosis is often missed or delayed because of its non-specific signs and symptoms. Treatments depend on patient’s characteristics. In contrast to conventional open surgery, endovascular therapy has been reported as an effective option with minimally invasion, low complication, short recovery time and good outcome, especially in high-risk patients. Case presentation. We describe a case of ruptured pseudoaneurysm of ileal artery, a branch of superior mesenteric artery, presenting with gastrointestinal bleeding signs while on anticoagulant therapy. Both upper and lower gastrointestinal endoscopy were inconclusive. The diagnosis was confirmed by angiography and the patient was successfully treated by coil embolization. Conclusions. Ruptured pseudoaneurysm of superior mesenteric artery and its branches should be suspected in patients with unexplained gastrointestinal hemorrhage. Endovascular intervention is a feasible approach, especially in patients with multiple comorbidities and high bleeding risk.

Keywords

• pseudoaneurysm
• superior mesenteric artery
• ileal artery
• endovascular therapy
• coil
• gastrointestinal bleeding