Median arcuate ligament syndrome (MALS) involves narrowing of the celiac artery root from MAL compression, leading to pancreatoduodenal artery aneurysm (PDAA) due to increased retrograde blood flow from the superior mesenteric artery into the PDA. We encountered a case in which coil embolization was performed for PDAA rupture due to MALS. Four years later, a second PDAA occurred and ruptured, necessitating coil reembolization. There have been no reports of recurrence during long-term follow-up after PDAA treatment in patients with MALS. We herein report a rare case of metachronous PDAA rupture in the context of MALS. The relevant literature and 11 PDAA/MALS cases are discussed.

Keywords: Median arcuate ligament syndrome (MALS); coil embolization; pancreatoduodenal artery aneurysm (PDAA).

腹侧横动脉综合征（MALS）涉及由于腹侧横动脉压迫而导致的脾动脉根部狭窄，进而因来自肠系膜上动脉的逆向血流增加而引发胰十二指肠动脉瘤（PDAA）。我们遇到一例因 MALS 导致 PDAA 破裂并进行了线圈栓塞治疗的情况。四年之后，患者再次出现第二个 PDAA 并且破裂，需要进行二次线圈再栓塞治疗。在长期随访中，尚未有关于 MALS 患者在接受 PDAA 治疗后复发的报告。本文报道一例罕见的 MALS 背景下异时性 PDAA 破裂病例，并讨论了相关文献和 11 个 PDAA/MALS 病例。

关键词：腹侧横动脉综合征（MALS）；线圈栓塞；胰十二指肠动脉瘤（PDAA）。