Embolotherapy of Ruptured Gastroepiploico-Colic Communicating Artery with Median Arcuate Ligament Syndrome: A Case Report

Abstract

Aneurysm of collateral vessels in celiac axis stenosis has seldom been reported. We report a case of hemoperitoneum due to spontaneous aneurysmal rupture of a previously unreported collateral vessel in a patient with median arcuate ligament syndrome. A 37-year-old man without any history of illness or trauma exhibited hemoperitoneum with an aneurysm in the right subhepatic area on CT. CT findings also included celiac stenosis due to median arcuate ligament thickening. Celiac and superior mesenteric artery angiography revealed an abnormal communicating artery aneurysm between the right gastroepiploic and right colic arteries. We named this aberrant anastomosis “gastroepiploico-colic communicating artery.” This rare collateral channel may cause spontaneous aneurysmal rupture in the presence of celiac stenosis. We successfully treated the aneurysmal rupture by transcatheter arterial embolization.

Keywords

• collateral circulation
• median arcuate ligament syndrome
• aneurysm
• embolization
• therapeutic
• ruptured
• vascular malformations