Interventional radiology and laparotomy for retroperitoneal bleeding associated with median arcuate ligament syndrome: two case reports

Abstract

We report two cases of retroperitoneal bleeding caused by median arcuate ligament syndrome in which one alive and the other dead after Interventional radiology （IVR） and laparotomy. Case 1：A 67-year-old man was performed laparotomy for intestinal necrosis after angioembolization, and he got well. Case 2：A 53-year-old woman was performed laparotomy after angioembolization, however the bleeding was continuing. Therefore, we performed second angioembolization. Three days later, she passed away of the wide duodenal necrosis. Discussion：We thought that the required time to stop bleeding and the presence of intraperitoneal bleeding are the points of life and death. Although IVR tends to the first choice for diagnosis and treatment, we should recognize the therapeutic limitations. Conclusion：We should stop bleeding as early as possible not adhering to only one procedure.