Abstract

A 69 year old woman presented with severe abdominal pain and haemodynamic instability. Computed tomography (CT) angiography demonstrated multiple ectasia of the visceral arteries and a massive haemoperitoneum. An exploratory laparotomy was performed. Multiple epiploic artery aneurysms with a string of beads aspect were found (A), one of which had ruptured. Total omentectomy was performed, and she was discharged from hospital after one week. Histopathological analysis of the epiploic arteries indicated fibromuscular dysplasia with intimal thickening (B, red asterisk) with no lesion of the vein (B, blue asterisk). Annual surveillance with a whole body CT scan has been arranged.Image 1

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