Nagasawa Hiroki, Yanagawa Youichi
Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN.
Cureus. 2024 Oct 2;16(10):e70692. doi: 10.7759/cureus.70692. eCollection 2024 Oct.
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.
自发性非动脉瘤性胃网膜动脉出血是一种罕见的情况，其与腹腔干压迫综合征（CACS）（也称为正中弓状韧带综合征（MALS））的关联更为罕见。此外，因排便用力导致的非创伤性腹腔内出血也很罕见。本研究报告了一例极其罕见的排便用力后发生的伴有CACS/MALS的非动脉瘤性胃网膜动脉出血病例。一名24岁男性在排便后突然出现左上腹疼痛。使用对比增强计算机断层扫描，该患者被诊断为胃网膜动脉出血和CACS/MALS。患者接受了紧急剖腹手术，随后的病理检查未发现动脉瘤。这是一例伴有CACS/MALS的非典型腹腔内出血病例，出血可能是由于血管脆性增加、动脉血压升高和止血障碍共同作用所致。
