Abstract
Objective: Gastroepiploic artery aneurysms (GEAAs) are rare, comprising 4-5% of visceral artery aneurysms, and are typically diagnosed after rupture. Here, we report a rare case of an unruptured right GEAA incidentally detected during a routine health checkup that was successfully treated with laparoscopic resection. Patient: An asymptomatic 74-year-old man presented with a 30-mm mass anterior to the pancreatic head that was incidentally detected during routine abdominal ultrasonography. Color Doppler confirmed internal arterial flow, and pulsed-wave Doppler imaging demonstrated a waveform consistent with an arterial aneurysm. Results: Contrast-enhanced computed tomography revealed a solitary, unruptured right GEAA with a mural thrombus and no calcification, atherosclerosis, or additional visceral artery aneurysms. The aneurysm's unclear etiology and favorable anatomical location supported the decision to perform a laparoscopic aneurysmectomy for diagnostic and therapeutic purposes. The surgery was performed without complications. The histopathological examination revealed a pseudoaneurysm with thrombus formation and atherosclerotic changes. The patient was discharged on day 5 with no signs of recurrence 3 months postoperatively. Conclusion: Ultrasonography is a useful diagnostic tool to detect unruptured right GEAAs during routine health checkups. Laparoscopic resection may be a safe and effective treatment option for unruptured solitary GEAAs of uncertain origin.