Differentiation of multiple visceral artery aneurysm rupture from major bleeding after coronary artery bypass grafting

Background Visceral artery aneurysm is a very rare disease, but it is clinically important because of the high risk of rupture involved. These ruptures must be differentiated from those that occur during hospitalization after extra‐abdominal surgery. Methods During hospitalization after off‐pump coronary artery bypass grafting, a 77‐year‐old woman developed hypovolemic symptoms and had decreased hemoglobin. There was no obvious bleeding, but while screening for possible complications after cardiac surgery, abdominal computed tomographic angiography showed multiple visceral artery aneurysms of the gastroduodenal and pancreaticoduodenal arteries along with hemoperitoneum. Results The patient underwent coil embolization of the visceral artery aneurysm and was discharged without any complications. Conclusions In patients with coronary artery disease with risk factors for atherosclerosis, if anemia occurs without apparent bleeding after surgery, visceral artery aneurysm should be considered as a differential diagnosis.