Left inferior phrenic arterial malformation mimicking gastric varices: A case report and review of literature

作者：Han Wang, Yi-Qing Tan, Ping Han, Anhui Xu, Han-Lin Mu, Zhe Zhu, Li Ma, Mei Liu, Huaping Xie · 发表于：World Journal of Gastrointestinal Surgery · 年份：2024 · DOI：10.4240/wjgs.v16.i9.3057 · 被引用次数：3 · 研究领域：Vascular Anomalies and Treatments、Gastrointestinal Bleeding Diagnosis and Treatment、Abdominal vascular conditions and treatments

BACKGROUND: Gastric submucosal arterial dilation resulting from splenic artery occlusion represents an exceedingly rare etiology of acute upper gastrointestinal bleeding (UGIB). Although endoscopy is a widely utilized diagnostic and therapeutic modality for gastrointestinal bleeding, it has limitations in detecting arterial abnormalities. CASE SUMMARY: This report presents a rare case of massive UGIB in a 57-year-old male with a tortuous left inferior phrenic artery accompanied by splenic artery occlusion. "Gastric varices" was identified during the patient's endoscopy one year before hemorrhage. Despite initial hemostasis by endoscopic clipping, the patient experienced massive rebleeding after one month, requiring intervention with transcatheter arterial embolization (TAE) to achieve hemostasis. CONCLUSION: This is the first case to report UGIB due to a tortuous left inferior phrenic artery. This case highlights the limitations of endoscopy in identifying arterial abnormalities and emphasizes the potential of TAE as a viable alternative for the management of arterial bleeding in the gastrointestinal tract.