A 73-year-old woman experienced acute abdominal pain, nausea and vomiting during hospitalization
for thalamic hemorrhage treatment. An emergent abdominal computed tomography scan
revealed bloody ascites and hematoma in the pararenal extraperitoneal space. Vital
signs were stable at the moment, however, three days later, the patient presented
with hemorrhagic shock. She was transferred to our hospital for further evaluation
and treatment. An emergent CT scan showed hematoma in the pararenal extraperitoneal
space. A 3D-CT revealed stenosis of the root the celiac artery with a distal dilation
(Fig. 1A; surrounded by a circle). Also, a digital subtraction angiography showed a spindle-shaped
aneurysm was formed at the posterior inferior pancreatic duodenal artery (PIPDA) (Fig. 1B; Arrowhead). Median arcuate ligament syndrome complicated with PIPDA aneurysm rupture
was confirmed in conjunction was diagnosed. The patient subsequently underwent a coil
embolization of the aneurysm.
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References
- Median arcuate ligament syndrome.J Vasc Surg. 2020 Jun; 71: 2170-2176
- Endovascular treatment of ruptured pancreaticoduodenal artery aneurysm with celiac axis stenosis.Ann Vasc Surg. 2019; 57: 273.e1-273.e5
- Median arcuate ligament syndrome- review of this rare disease.JAMA Surg. 2016; 151: 471
Article info
Publication history
Published online: July 27, 2022
Accepted:
July 22,
2022
Received:
November 30,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
