Median arcuate ligament syndrome with retroperitoneal hemorrhage
Acute abdominal pain.
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Important right retroperitoneal hemorrhage is seen with small aneurysm or pseudoaneurysm suspected on the speculated location of the pancreaticoduodenal arteries. Also, the celiac trunk seems kinked proximally by the median arcuate ligament. This finding was confirmed on sagittal reconstructions.
The patient was referred to the team of interventional radiology.
Angiography is not shown here but small pancreaticoduodenal aneurysms were responsible for the retroperitoneal hemorrhage. They were embolized and the patient was stabilized.
An association with median arcuate ligament syndrome and pancreaticoduodenal aneurysms has been described in the literature (see below).