Rupture of middle colic artery pseudoaneurysm

A 61-year-old man with acute onset of epigastric discomfort with hemorrhagic shock was diagnosed of rupture of middle colic artery (MCA) pseudoaneurysm by computed tomography of abdomen with contrast enhancement. After consulting the general surgeon and the radiologist, transcatheter arterial embolization was arranged. Aneurysms from superior mesenteric arterial branch, especially MCA aneurysm, are extremely rare. Conservative treatment may be considered if the patient is clinically stable and no evidence of indicating ruptured aneurysm or ischemic bowel change. In the past era, surgical intervention is the treatment of choice for rupture of visceral artery aneurysms. We describe a rare case of rupture of MCA pseudoaneurysm managed with transcatheter arterial embolization successfully under hemodynamic unstable situation without further laparotomy. As the improvement and development of interventional vascular techniques, endovascular therapy may be considered as an alternative and safe therapy.