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Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis

Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament (MAL) causes compression of the coeliac trunk. The chronic compression leads to coeliac trunk luminal narrowing and reduced blood supply to the abdominal splanchnic organs with possible local complicatio...

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Autores principales: Rebelos, Eleni, Cipriano, Alessandro, Ferrini, Laura, Trifirò, Silvia, Napoli, Niccolò, Santini, Massimo, Napoli, Vinicio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660059/
https://www.ncbi.nlm.nih.gov/pubmed/31428773
http://dx.doi.org/10.1093/omcr/omz067
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author Rebelos, Eleni
Cipriano, Alessandro
Ferrini, Laura
Trifirò, Silvia
Napoli, Niccolò
Santini, Massimo
Napoli, Vinicio
author_facet Rebelos, Eleni
Cipriano, Alessandro
Ferrini, Laura
Trifirò, Silvia
Napoli, Niccolò
Santini, Massimo
Napoli, Vinicio
author_sort Rebelos, Eleni
collection PubMed
description Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament (MAL) causes compression of the coeliac trunk. The chronic compression leads to coeliac trunk luminal narrowing and reduced blood supply to the abdominal splanchnic organs with possible local complications such as pseudo-aneurysms and spontaneous bleeding. Its incidence is probably underestimated due to the poor availability of color Doppler ultrasonography (CD-US), especially in an Emergency Department (ED) setting. A 44-year old woman presented to Pisa University Hospital ED with acute abdominal pain. An abdominal ultrasonography scan (US scan) was performed showing the presence of free liquid in the Douglas pouch. The abdominal computed tomography scan (CT scan) highlighted the presence of a large mesenteric hematoma. A CD-US revealed a significant stenosis of the coeliac artery. A selective angiography confirmed the diagnosis of MALS with a pseudo-aneurysm of the inferior pancreatic-duodenal artery, which was successfully embolized.
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spelling pubmed-66600592019-08-02 Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis Rebelos, Eleni Cipriano, Alessandro Ferrini, Laura Trifirò, Silvia Napoli, Niccolò Santini, Massimo Napoli, Vinicio Oxf Med Case Reports Case Report Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament (MAL) causes compression of the coeliac trunk. The chronic compression leads to coeliac trunk luminal narrowing and reduced blood supply to the abdominal splanchnic organs with possible local complications such as pseudo-aneurysms and spontaneous bleeding. Its incidence is probably underestimated due to the poor availability of color Doppler ultrasonography (CD-US), especially in an Emergency Department (ED) setting. A 44-year old woman presented to Pisa University Hospital ED with acute abdominal pain. An abdominal ultrasonography scan (US scan) was performed showing the presence of free liquid in the Douglas pouch. The abdominal computed tomography scan (CT scan) highlighted the presence of a large mesenteric hematoma. A CD-US revealed a significant stenosis of the coeliac artery. A selective angiography confirmed the diagnosis of MALS with a pseudo-aneurysm of the inferior pancreatic-duodenal artery, which was successfully embolized. Oxford University Press 2019-07-26 /pmc/articles/PMC6660059/ /pubmed/31428773 http://dx.doi.org/10.1093/omcr/omz067 Text en © The Author(s) 2019. Published by Oxford University Press. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Rebelos, Eleni
Cipriano, Alessandro
Ferrini, Laura
Trifirò, Silvia
Napoli, Niccolò
Santini, Massimo
Napoli, Vinicio
Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
title Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
title_full Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
title_fullStr Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
title_full_unstemmed Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
title_short Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
title_sort spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6660059/
https://www.ncbi.nlm.nih.gov/pubmed/31428773
http://dx.doi.org/10.1093/omcr/omz067
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