Imaging of retroperitoneal haemorrhage revealing median arcuate ligament syndrome

Area of Science:

• Vascular Surgery
• Gastroenterology
• Medical Case Reports

Background:

• Median arcuate ligament syndrome (MALS) involves compression of the celiac artery.
• This compression can lead to secondary aneurysms in the pancreaticoduodenal arteries.
• Rupture of these aneurysms can cause severe retroperitoneal hemorrhage.

Purpose of the Study:

• To describe a series of patients with median arcuate ligament syndrome complicated by spontaneous retroperitoneal hemorrhage.
• To highlight the diagnostic challenges and clinical presentation of this rare vascular complication.

Main Methods:

• Case series review of three patients.
• Clinical presentation, diagnostic imaging, and management strategies were analyzed.

Main Results:

• All three patients presented with sudden epigastric pain and were initially diagnosed with spontaneous hematoma.
• Diagnosis of median arcuate ligament syndrome and associated aneurysmal rupture was confirmed.
• Successful management strategies were employed for the patients.

Conclusions:

• Median arcuate ligament syndrome is a potential cause of spontaneous retroperitoneal hemorrhage due to pancreaticoduodenal artery aneurysms.
• Sudden epigastric pain and hematoma should raise suspicion for this underlying condition.
• Early diagnosis and appropriate intervention are crucial for managing this rare but life-threatening complication.