Spontaneous rupture of the right gastroepiploic artery: unusual cause of acute abdomen and shock

We present a case of a 64-year old woman with a Spontaneous rupture of the right gastroepiploic artery with hemorrhagic shock that was successfully treated by emergency surgery.Simultaneous restoration of circulating volume and rapid diagnosis are keys in determining the patient outcome in this situation. Though the mortality is high if untreated, the operation is relatively simple and carries a low risk.Spontaneous rupture of the right gastroepiploic artery is an extremely rare case which can be a cause of abdominal apoplexy, and which should be considered in the differential diagnosis of unexplained hemorrhagic shock and if hemoperitoneum is encountered while performing a laparotomy. Simultaneous restoration of circulating volume and rapid diagnosis are keys in determining the patient outcome. Though the mortality is high if untreated, the operation is relatively simple and carries a low risk.A 64-year old woman was presented to the emergency department with acute abdominal pain and breathlessness of which she was suffering few hours before her presentation to the emergency room. Her medical history revealed recurrent upper abdominal discomfort over the last 4 months, and did not suggest any major disease except hypertension, that she has been treating since seven years. Besides, she had no prior history of abdominal surgery or trauma.The physical examination revealed a conscious woman with discolored conjunctives and severe cutaneous paleness, shortness of breath, tachycardia with a weak and rapid pulse rate of 126 beat per minute, and hypotension with a systolic blood pressure of 80 mmHg. At the abdominal examination, there was a general abdominal tenderness.Laboratory data showed a white blood cell count of 7 900/mm3, a hematocrit of 18%, and serum hemoglobin concentration of 6,1 g/dl, with a normal blood platelet level (390 000/mm3), a blood urea of 0,25 g/L, and a creatinine level of 10 mg/L. Hemostasis laboratory data, chemistry and Serum lipase were within