A Case of Laparoscopic Surgery for Pancreaticoduodenal Artery Aneurysm Caused by Median Arcuate Ligament Syndrome

Abstract

Pancreaticoduodenal artery (PDA) aneurysms are rare visceral aneurysms often associated with median arcuate ligament syndrome (MALS) due to compensatory high blood flow. Although endovascular treatment is the preferred approach, challenges such as contrast agent allergies and proximity to the superior mesenteric artery (SMA) may render such treatment unsuitable. Herein, we present a case of a 50-year-old female with a PDA aneurysm caused by MALS. Endovascular treatment was contraindicated because of contrast allergies and anatomical considerations. Laparoscopic surgery was performed to resect both the PDA aneurysm and the median arcuate ligament (MAL), marking the first reported case to use this approach. The procedure was successful, with no complications, and the patient was discharged on the fourth postoperative day. This case highlights the potential of laparoscopic surgery as a minimally invasive alternative for managing PDA aneurysms in complex clinical scenarios.