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Segmental arterial mediolysis is a rare vascular disease that leads to spontaneous intra-abdominal haemorrhage, which causes shock and bowel ischaemia, and is associated with a high mortality rate. Here, we present a case of spontaneous intra-abdominal haemorrhage due to segmental arterial mediolysis in a patient who underwent oesophagocolojejunostomy for synchronous triple primary cancer, which was treated successfully by coil embolization. We conclude that a preoperative angiogram is necessary to detect vascular abnormalities, and in cases with severe haemorrhage, an urgent endovascular procedure is the treatment of choice.

Spontaneous intra-abdominal haemorrhage due to segmental arterial mediolysis following oesophagocolojejunostomy†