{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T22:33:37Z","timestamp":1789166017902,"version":"build-2803163510"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T00:00:00Z","timestamp":1564099200000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament (MAL) causes compression of the coeliac trunk. The chronic compression leads to coeliac trunk luminal narrowing and reduced blood supply to the abdominal splanchnic organs with possible local complications such as pseudo-aneurysms and spontaneous bleeding. Its incidence is probably underestimated due to the poor availability of color Doppler ultrasonography (CD-US), especially in an Emergency Department (ED) setting.<\/jats:p>\n               <jats:p>A 44-year old woman presented to Pisa University Hospital ED with acute abdominal pain. An abdominal ultrasonography scan (US scan) was performed showing the presence of free liquid in the Douglas pouch. The abdominal computed tomography scan (CT scan) highlighted the presence of a large mesenteric hematoma. A CD-US revealed a significant stenosis of the coeliac artery. A selective angiography confirmed the diagnosis of MALS with a pseudo-aneurysm of the inferior pancreatic-duodenal artery, which was successfully embolized.<\/jats:p>","DOI":"10.1093\/omcr\/omz067","type":"journal-article","created":{"date-parts":[[2019,7,26]],"date-time":"2019-07-26T17:10:11Z","timestamp":1564161011000},"source":"Crossref","is-referenced-by-count":5,"title":["Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis"],"prefix":"10.1093","volume":"2019","author":[{"given":"Eleni","family":"Rebelos","sequence":"first","affiliation":[{"name":"U.O. Medicina d\u2019Urgenza e Pronto Soccorso, Emergency Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Cipriano","sequence":"additional","affiliation":[{"name":"U.O. Medicina d\u2019Urgenza e Pronto Soccorso, Emergency Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ferrini","sequence":"additional","affiliation":[{"name":"U.O. Medicina d\u2019Urgenza e Pronto Soccorso, Emergency Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Trifir\u00f2","sequence":"additional","affiliation":[{"name":"U.O. Medicina d\u2019Urgenza e Pronto Soccorso, Emergency Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Napoli","sequence":"additional","affiliation":[{"name":"Division of General and Transplant Surgery, University of Pisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Santini","sequence":"additional","affiliation":[{"name":"U.O. Medicina d\u2019Urgenza e Pronto Soccorso, Emergency Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicio","family":"Napoli","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, University of Pisa, Via Paradisa, Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,7,26]]},"reference":[{"key":"2019082001451323300_ref1","first-page":"381","article-title":"The anatomic basis for respiratory variation in median arcuate ligament compression of the celiac artery","volume":"73","author":"Reuter","year":"1973","journal-title":"Surgery"},{"key":"2019082001451323300_ref2","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/00000658-195905000-00009","article-title":"The pattern of arteriosclerotic narrowing of the celiac and superior mesenteric arteries","volume":"149","author":"Derrick","year":"1959","journal-title":"Ann Surg"},{"key":"2019082001451323300_ref3","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1053\/svas.2001.25498","article-title":"Screening for mesenteric vascular insufficiency and follow-up of mesenteric artery bypass procedures","volume":"14","author":"Moneta","year":"2001","journal-title":"Semin Vasc Surg"},{"key":"2019082001451323300_ref4","first-page":"5","article-title":"Ultrasound of the median arcuate ligament syndrome: a new approach to diagnosis","volume":"14","author":"Gruber","year":"2012","journal-title":"Med Ultrason"},{"key":"2019082001451323300_ref5","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1001\/jamasurg.2016.0002","article-title":"Median arcuate ligament syndrome-review of this rare disease","volume":"151","author":"Kim","year":"2016","journal-title":"JAMA Surg"}],"container-title":["Oxford Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/omcr\/article-pdf\/2019\/7\/omz067\/29189358\/omz067.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T05:45:20Z","timestamp":1566279920000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/omcr\/article\/doi\/10.1093\/omcr\/omz067\/5539003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,1]]},"references-count":5,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/omcr\/omz067","relation":{},"ISSN":["2053-8855"],"issn-type":[{"value":"2053-8855","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,7]]},"published":{"date-parts":[[2019,7,1]]},"article-number":"omz067"}}