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The American Journal of Forensic Medicine and Pathology:
June 2008 - Volume 29 - Issue 2 - p 191–195
doi: 10.1097/PAF.0b013e318174f0b9
Case Report

A Gastric Artery Aneurysm Complicated by a Dissection of Gastric and Hepatic Arteries: Possible Role of Adventitial Inflammation and Disruption of Internal Elastic Lamina in Splanchnic Artery Dissection

Kobayashi, Masahiko MD, PhD; Mellen, Paul F. MD

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Abstract

A 77-year-old woman was found deceased at home. An autopsy examination revealed a hemoperitoneum due to a ruptured false aneurysm of a branch of the left gastric artery. A long dissection extending from the aneurysm involved splanchnic arteries including the left gastric, common hepatic, right and left branches of proper hepatic, and intrahepatic arteries. An intimal tear was identified in the common hepatic artery. Neutrophils infiltrating in the adventitia may have been reactive and may have triggered the adventitial rupture of aneurysm or development of the dissection. Disruption of the internal elastic lamina, which has been proposed to cause dissection of intracranial arteries, was seen in the dissected arteries. Little is currently known about aneurysms or dissections of splanchnic arteries; however, observation of adventitial inflammation and internal elastic lamina may help disclose the etiology and pathogenesis.

© 2008 Lippincott Williams & Wilkins, Inc.

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