Abstract
Gastric artery aneurysm is a rare and lethal condition, and is caused by inflammatory or degenerative vasculopathies. We describe herein the clinical course of a patient with a ruptured gastric artery aneurysm associated with microscopic polyangiitis. Absence of vasculitic changes in the aneurysm resected and negative results of autoantibodies interfered with our diagnostic process. We should have adopted an interventional radiology and initiated steroid therapy promptly to rescue the patient.