case_images: PMC11830479_01
case_images: Fig. 1 Preoperative CT and intraoperative angiography. (A) Sagittal view of the right gastric artery measuring 8 mm (arrow). (B) Three-dimensional reconstructed CT image of the right gastric artery (arrow). (C) Angiography of the celiac artery showing the right gastric artery (arrow). (D) The aneurysm in the right gastric artery was completely resected. Arrows indicate the clips on the inflow and outflow arteries. CT: computed tomography
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case_images: figure1
case_images: A contrast-enhanced computed tomography (CT) revealed an 8-mm right gastric artery (Figs. 1A and 1B). With the patient under general anesthesia, a 4Fr sheath was inserted into the right femoral artery, and angiography of the celiac artery was performed, showing a right gastric artery aneurysm (Fig. 1C). Since angiography was possible with the sheath and catheter used for endovascular treatment, a final angiography was performed and complete resection of the right gastric artery aneurysm was confirmed (Fig. 1D).
case_images: Fig. 2 Intraoperative findings during laparoscopic surgery. (A) Schema of port location during laparoscopic surgery. (B) The right gastric artery aneurysm (arrow) was easily identified. (C) Inflow and outflow arteries of the aneurysm were clipped using 5-mm clips.
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case_images: figure2
case_images: A 12-mm trocar was inserted through the umbilicus, and two additional 5-mm trocars were inserted into the right and left upper quadrants (Fig. 2A). The right gastric artery aneurysm was easily identified (Fig. 2B). The inflow and outflow arteries of the aneurysm were clipped with 5-mm clips (Fig. 2C), and the aneurysm was excised.
case_images: Fig. 3 Pathological insights. (A) Macroscopic examination of resected aneurysm. (B) Hematoxylin and eosin staining (100x) revealed only the formation of atheroma and thinning of the tunica media.
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case_images: figure3
case_images: The histopathological diagnosis revealed only the formation of atheroma and thinning of the tunica media, while no fibromuscular dysplasia or segmental arterial mediolysis (SAM) was observed (Fig. 3).