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Published on: November 15, 2024
Gastric Dieulafoy Lesion Bleeding Associated with Hemodynamic Alterations in Median Arcuate Ligament Syndrome: A Case
Mitsunori Kusuhara1, Akiko Ohno1, Jun Miyoshi1
1Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Japan.
Abstract:
Median arcuate ligament syndrome (MALS) involves compression of the celiac artery and it can cause a hemodynamic disturbance. We report a case of acute upper gastrointestinal bleeding from a Dieulafoy lesion arising from the collateral arterial circulation, considered secondary to MALS. Although initial hemostasis was achieved by endoscopic clipping, given the aneurysmal appearance and the presence of a developed collateral circulation on computed tomography, an interventional radiology evaluation and transcatheter arterial embolization were performed to prevent rebleeding. Surgery was performed two months later for median arcuate ligament division and aorto-celiac bypass. No recurrence or abnormal vascular findings were identified during the >5 years of follow-up.
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