Retroperitoneal Hematoma: Rupture of Aneurysm in the Arc of Bühler Caused by Median Arcuate Ligament Syndrome.
Keiichiro AbeMakoto IijimaKeiichi TominagaSatoshi MasuyamaNaoya IzawaYuichi MajimaAtsushi IrisawaPublished in: Clinical medicine insights. Case reports (2019)
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.
Keyphrases
- computed tomography
- contrast enhanced
- coronary artery
- case report
- magnetic resonance imaging
- diffusion weighted
- positron emission tomography
- dual energy
- abdominal aortic aneurysm
- magnetic resonance
- abdominal pain
- neuropathic pain
- image quality
- spinal cord
- diffusion weighted imaging
- minimally invasive
- single cell
- chronic kidney disease
- optical coherence tomography
- coronary artery bypass
- current status
- pain management
- physical activity
- optic nerve
- surgical site infection
- pet ct