A case of ruptured aneurysm of the middle colic artery is reported. A 44-year-old woman was admitted to the hospital because of severe upper abdominal pain. After a few minutes from arrival, she fell into a shock state.
Ultrasonotomography and computed tomography revealed intraabdominal hemorrhage. Angiography visualized a rupture of an aneurysm. Emergency operation was done and a large amount of blood with clot was present in the abdominal cavity. When the blood with clot was removed, a pulsatile bleeding site near the beginning of the middle colic artery was revealed. Since bleeding from the middle colic artery continued, the aneurysm was resected. The rupture of the aneurysm of the middle colic artery has been reported in only 14 cases in Japan. We find a great deal of difficulty in preopertive diagnosis, but the prognosis of the disease is good if early surgical hemostasis is successfully achieved. So the opportunity of the operation should not be missed.