Retroperitoneal Hematoma: Rupture of Aneurysm in the Arc of Bühler Caused by Median Arcuate Ligament Syndrome. Issue 12 (February 2019)

• Record Type: Journal Article
• Authors: Abe, Keiichiro; Iijima, Makoto; Tominaga, Keiichi; Masuyama, Satoshi; Izawa, Naoya; Majima, Yuichi; Irisawa, Atsushi
• Is Part Of: Clinical medicine insights. Issue 12(2019)
• Publication Date: 2019-02
• Subjects: Aneurysm -- Arc of Bühler -- Median arcuate ligament syndrome; Clinical medicine -- Case studies -- Periodicals; Medicine; Clinical medicine; Electronic journals; Case Reports; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; Case studies; Periodicals; 616.09
• DOI: 10.1177/1179547619828716
• Languages: English
• ISSNs: 1179-5476

Abstract

We herein report a case with aneurysm rupture in the arc of Bühler (AOB) caused by median arcuate ligament syndrome (MALS). The patient experienced a sudden onset of upper abdominal pain. Contrast-enhanced abdominal computed tomography (CT) showed an iso- to hyper-enhancing area mainly ranging from the dorsal aspect of the pancreatic head to the retroperitoneum around the right kidney. Abdominal angiography revealed marked stenosis in the origin of the celiac artery caused by MALS and a 7-mm saccular aneurysm in the AOB. Thus, we diagnosed the pain as having been caused by aneurysm rupture in the AOB due to MALS. The patient's symptoms and anemia also improved to normal range without surgery. Careful follow-up, considering possible recurrence of aneurysm at other sites in the future, is essential.