Median arcuate ligament syndrome with retroperitoneal haemorrhage:A case report  

作　　者：Xiao-Chen Lu Jian-Guo Pei Guang-Hua Xie Yong-Yu Li Hong-Mei Han 

机构地区：[1]Department of Gastroenterology,Affiliated Hospital of Yanbian University,Yanji 133000,Jilin Province,China [2]Department of Imaging,Affiliated Hospital of Yanbian University,Yanji 133000,Jilin Province,China [3]Department of Hepatobiliary Surgery,Affiliated Hospital of Yanbian University,Yanji 133000,Jilin Province,China

出　　处：《World Journal of Clinical Cases》2022年第21期7509-7516,共8页世界临床病例杂志

摘　　要：BACKGROUND Median arcuate ligament syndrome(MALS)is relatively rare and is due to extraluminal compression of the coeliac artery by the median arcuate ligament of the diaphragm.Here,we report a case of MALS found in a patient with abdominal pain and retroperitoneal haemorrhage for education and dissemination.CASE SUMMARY This article describes a 46-year-old female patient who was admitted to our hospital with abdominal pain as her chief complaint.She had experienced no obvious symptoms but had retroperitoneal bleeding during the course of the disease.Contrast-enhanced computed tomography(CT)and noninvasive CT angiography(CTA)led to an initial misdiagnosis of pancreaticoduodenal artery aneurysm(PDAA)causing retroperitoneal hemorrhage.After intraoperative exploration and detailed analysis of enhanced CT and CTA images,a final diagnosis of MALS was made.The cause of the haemorrhage was bleeding from a branch of the gastroduodenal artery,not rupture of a PDAA.The prognosis of MALS combined with PDAA treated by laparoscopy and interventional therapy is still acceptable.The patient was temporarily treated by gastroduodenal suture haemostasis and was referred for further treatment.CONCLUSION MALS is very rare and usually has postprandial abdominal pain,upper abdominal murmur,and weight loss.It is diagnosed by imaging or due to complications.When a patient has abdominal bleeding or PDAA,we should consider whether the patient has celiac trunk stenosis(MALS or other etiology).When abdominal bleeding is combined with an aneurysm,we generally think of aneurysm rupture and hemorrhage first,but it may also be collateral artery rupture and hemorrhage.

关 键 词：Median arcuate ligament syndrome Retroperitoneal haemorrhage Pancreaticoduodenal artery aneurysm Case report 

分 类 号：R656[医药卫生—外科学]