Abstract
A 46-year-old female without prior underlying disease presented with 3 days of abdominal pain. Her blood pressure was 123/78 mm Hg, and her heart rate was 105 beats/min. Laboratory data revealed elevated white blood cell count of 23.8 (1,000 cells/μL) and C-reactive protein level of 11.66 (mg/L). Computed tomography (CT) angiography revealed hemoperitoneum and an aneurysm at the left side of the abdomen (Fig 1). Emergent transarterial embolization was planned. The angiography showed an 8.8-mm saccular aneurysm located at the arc of Riolan artery connecting the left colic artery to the superior mesenteric artery (Figs 2, 3). Coil embolization using a sandwich technique was successfully performed (Fig 4). Symptoms subsided, and no abdominal complications or discomfort were noted during her 18-month follow-up. However, no subsequent laboratory or clinical workup for the underlying cause was performed by the physician. Figure 2Angiography from the superior mesenteric artery shows an enlarged and tortuous course of bridging artery (arrow). View Large Image Figure Viewer Download Hi-res image Figure 3Angiography from the inferior mesenteric artery shows the arc of Riolan artery (arrow) and a saccular aneurysm (dashed arrow). View Large Image Figure Viewer Download Hi-res image Figure 4Post-coil embolization of an aneurysm (arrow) at the arc of Riolan artery. View Large Image Figure Viewer Download Hi-res image
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