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Case Report
Acute intragastric rupture of a giant splenic artery aneurysm requiring emergent multidisciplinary intervention: A case report
1 Attending General Surgeon, Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
2 Resident General Surgeon, Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
3 Associate Professor, Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
4 Associate Professor, Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
5 Professor, Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
Address correspondence to:
Leyla Zeynep Tigrel
MD, Attending General Surgeon, Department of General Surgery, Istanbul Medeniyet University Faculty of Medicine, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Goztepe 34722, Kadikoy, Istanbul,
Turkey
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Article ID: 101543Z01LT2026
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How to cite this article
Tigrel LZ, Buyuker F, Ergun A, Asik M, Ekinci O, Alimoglu O. Acute intragastric rupture of a giant splenic artery aneurysm requiring emergent multidisciplinary intervention: A case report. Int J Case Rep Images 2026;17(2):17–21.ABSTRACT
Introduction: Splenic artery aneurysms (SAAs) are a rare pathology of the visceral vessels with a prevalence of less than 1%. While usually silent, spontaneous rupture represents a surgical emergency. This case report details the successful multidisciplinary management of an acute, massive intragastric rupture of a 9.5 cm giant SAA in a previously healthy 39-year-old male, emphasizing the diagnostic challenges and critical therapeutic transitions.
Case Report: A 39-year-old male experienced a sudden syncopal episode while on duty. He developed massive hematemesis, and an emergency upper gastrointestinal endoscopy revealed an ulcerated mass at the fundus of the stomach with active massive hemorrhage. Initial targeted embolization attempts failed to control the proximal inflow, and the patient rapidly deteriorated into severe hemorrhagic shock. Intraoperatively, a giant aneurysm was identified at the origin of the splenic artery, which had directly eroded through the posterior gastric wall into the gastric lumen. The splenic artery was rapidly dissected and ligated, the aneurysm was excised, the posterior gastric wall defect underwent primary repair, and a splenectomy was performed. Measuring 9.5 cm on pathological examination, the case presented herein represents the largest recorded splenic artery aneurysm presenting with an acute intragastric rupture in the medical literature.
Conclusion: Acute intragastric rupture of a giant splenic artery aneurysm is a life-threatening emergency that mimics routine upper gastrointestinal bleeding. When endovascular interventions fail or hemodynamic instability worsens, immediate open surgical control is definitive. This case highlights the critical importance of maintaining a high index of suspicion and utilizing rapid, multidisciplinary coordination between interventional radiology, surgery, and critical care.
Keywords: Aneurysm rupture, Case report, Gastrointestinal hemorrhage, Splenic artery aneurysm
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Acknowledgments
The authors would like to thank the clinical and administrative staff of Medeniyet University Göztepe Prof. Dr. Süleyman Yalçin City Hospital for their assistance and support in conducting this study.
Declaration of Generative AI and AI-assisted technologies in the manuscript preparation process
Generative AI technology was used during the preparation of this manuscript solely for the purpose of language editing, text structural formatting, and word-count optimization of the abstract and author contribution sections. No AI-generated scientific data, clinical findings, or medical literature interpretations were introduced into the text.
• Technology Name/Model: Gemini
• Version/Source: Gemini 1.5 Pro (Google)
• Specific Sections Utilizing Technology: Language refinement and structural separation of the Abstract (Introduction, Case Report, and Conclusion blocks) and alignment of the Author’s Contributions section to the journal’s template format.
Author ContributionsLeyla Zeynep Tigrel - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Fatih Buyuker - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Aysegul Ergun - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Murat Asik - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ozgur Ekinci - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Orhan Alimoglu - Substantial contributions to conception and design, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Leyla Zeynep Tigrel et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
