Spontaneous Retroperitoneal Hemorrhage Secondary to Chronic Celiac Axis Compression Treated with Embolization Utilizing Cone Beam CT

Abstract

Median arcuate ligament syndrome (MALS) is a rare and often misdiagnosed vascular pathology. In this paper, we discuss a 51-year-old female with MALS presenting with hypotension due to retroperitoneal hemorrhage. Currently, there is no consensus regarding the optimal treatment approach for such patients. This case report demonstrates the utility of conventional mesenteric angiography, cone beam CT with 3D reconstruction, and selective mesenteric transarterial embolization as an effective treatment approach for patients with spontaneous aneurysm rupture in MALS.

Spontaneous retroperitoneal bleeding secondary to celiac artery compression syndrome

“…Performing surgical ligament release in CACS patients with ruptured aneurysms is not yet established. 3,13 Abdominal artery release surgery is expected to improve the symptoms of CACS and prevent subsequent aneurysms, but its long-term effects are unknown. In this case, after discussing the benefits and risks of surgery with the patient, we chose to observe the patient without performing surgery.…”

Spontaneous retroperitoneal bleeding secondary to celiac artery compression syndrome

“…Surgical treatment is also indicated when embolization is unsuccessful. Performing surgical ligament release in CACS patients with ruptured aneurysms is not yet established 3,15,16 . Abdominal artery release surgery is expected to improve the symptoms of CACS and prevent subsequent aneurysms, but its long‐term effects are unknown.…”