Non-aneurysmal Gastroepiploic Arterial Hemorrhage With Median Arcuate Ligament Syndrome.

Spontaneous non-aneurysmal gastroepiploic arterial hemorrhage is a rare occurrence, and its association with celiac axis compression syndrome (CACS), also referred to as median arcuate ligament syndrome (MALS), is even more uncommon. Furthermore, nontraumatic intraperitoneal hemorrhage due to defecation strain is also rare. This study reports an extremely rare case of non-aneurysmal gastroepiploic arterial hemorrhage with CACS/MALS after defecation strain. A 24-year-old man presented with a sudden upper abdominal pain on the left side after defecation. The patient was diagnosed with bleeding from the gastroepiploic artery and CACS/MALS using contrast-enhanced computed tomography. The patient underwent urgent laparotomy, and subsequent pathogenic examination revealed no aneurysm. This was an atypical case of intraperitoneal hemorrhage with CACS/MALS, and hemorrhage may have occurred due to a combination of vascular fragility, elevated arterial blood pressure, and hemostatic disorder.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, Nagasawa et al.)