Aneurysm rupture in median arcuate ligament syndrome leading to duodenal stenosis: A case report.

IF 1 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

World Journal of Clinical Cases Pub Date : 2025-09-06 DOI:10.12998/wjcc.v13.i25.106089

Tomohiro Tanikawa, Keisuke Miyake, Mayuko Kawada, Katsunori Ishii, Takashi Fushimi, Noriyo Urata, Nozomu Wada, Ken Nishino, Mitsuhiko Suehiro, Miwa Kawanaka, Hidenori Shiraha, Ken Haruma, Hiroyasu Fujiwara, Tomoki Yamatsuji, Hirofumi Kawamoto

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Abstract

Background: A 56-year-old female presented with acute abdominal pain due to a ruptured pseudoaneurysm associated with median arcuate ligament syndrome (MALS), a rare condition caused by the compression of the celiac artery by the median arcuate ligament (MAL), potentially leading to ischemia, aneurysm formation, and rupture.

Case summary: Computed tomography revealed a retroperitoneal hematoma, celiac artery stenosis, and two aneurysms in the inferior pancreaticoduodenal artery. Hemostasis was achieved using transcatheter arterial embolization. However, 15 days after embolization, the patient developed duodenal stenosis, manifesting as gastric distension and nausea without abdominal pain. Endoscopy revealed mucosal edema and luminal narrowing of the duodenum. Conservative treatment was ineffective, and the patient underwent MAL transection and gastrojejunostomy. She recovered uneventfully, and follow-up at 4 months showed complete resolution of duodenal stenosis and no recurrence.

Conclusion: This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.

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正中弓状韧带综合征动脉瘤破裂致十二指肠狭窄1例。

背景：一名56岁女性，因假性动脉瘤破裂并正中弓状韧带综合征（MALS）引起急性腹痛，这是一种罕见的疾病，由正中弓状韧带（MAL）压迫腹腔动脉引起，可能导致缺血、动脉瘤形成和破裂。病例总结：计算机断层扫描显示腹膜后血肿，腹腔动脉狭窄，胰十二指肠下动脉两个动脉瘤。经导管动脉栓塞止血。但栓塞15天后，患者出现十二指肠狭窄，表现为胃胀、恶心，无腹痛。内镜检查显示粘膜水肿和十二指肠管腔狭窄。保守治疗无效，患者行MAL横断及胃空肠造口术。术后4个月随访显示十二指肠狭窄完全消失，无复发。结论：本病例强调了肌萎缩侧索硬化症早期诊断和多学科治疗的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Clinical Cases Medicine-General Medicine

自引率

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发文量

3384

期刊介绍： The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.