A Case Report of Stent Placement for Celiac Artery Stenosis Caused by Median Arcuate Ligament Compression Syndrome

Abstract

A 59–year–old man arrived at the hospital by ambulance complaining of abdominal pain. A contrast CT scan revealed celiac artery stenosis, a retroperitoneal hematoma around the duodenal second portion and the pancreatic head, and the dilation of the inferior pancreatic duodenal artery. The superior mesenteric artery was imaged and the inferior pancreatic duodenal artery was dilated, but no aneurysm was noted. In addition, the common hepatic artery contained contrast medium. Thus, the rupture of the pancreatic duodenal artery arcade was thought to have been caused by median arcuate ligament syndrome (MALS), and a balloon–expandable stent of 6 × 18 mm was placed at the origin of the celiac artery. In the final imaging study, the common hepatic artery was imaged with antegrade. The postoperative course was good, and a contrast CT examination performed 6 months later showed the patency of the stent and the shrinkage of the retroperitoneal hematoma. We report a case of successful stent placement for celiac artery stenosis caused by MALS and resulting in retroperitoneal hemorrhage.