{"title":"正中弓状韧带综合征动脉瘤破裂致十二指肠狭窄1例。","authors":"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","doi":"10.12998/wjcc.v13.i25.106089","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case summary: </strong>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.</p><p><strong>Conclusion: </strong>This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 25","pages":"106089"},"PeriodicalIF":1.0000,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243907/pdf/","citationCount":"0","resultStr":"{\"title\":\"Aneurysm rupture in median arcuate ligament syndrome leading to duodenal stenosis: A case report.\",\"authors\":\"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\",\"doi\":\"10.12998/wjcc.v13.i25.106089\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Case summary: </strong>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.</p><p><strong>Conclusion: </strong>This case highlights the importance of the early diagnosis and multidisciplinary management of MALS.</p>\",\"PeriodicalId\":23912,\"journal\":{\"name\":\"World Journal of Clinical Cases\",\"volume\":\"13 25\",\"pages\":\"106089\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12243907/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Clinical Cases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.12998/wjcc.v13.i25.106089\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Clinical Cases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.12998/wjcc.v13.i25.106089","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Aneurysm rupture in median arcuate ligament syndrome leading to duodenal stenosis: A case report.
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.
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.
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