Introduction
Celiac artery compression syndrome (CACS) is a rare disorder characterized by chronic epigastric pain due to celiac artery compression by median arcuate ligament overgrowth.1This syndrome is also known as median arcuate ligament syndrome or Dunbar syndrome. Its diagnosis requires confirmation of celiac artery stenosis, exclusion of other diseases, and characteristic symptoms. It is associated with visceral aneurysms and dissection, involving the celiac, mesenteric, and pancreaticoduodenal arteries.2, 3 The mortality rate for ruptured abdominal aneurysms is high, and early detection and treatment are critical.4 Herein, we report a case of a 56-year-old Japanese woman with sudden epigastric pain, who was diagnosed with acute retroperitoneal hemorrhage secondary to isolated posterior inferior pancreaticoduodenal artery (PIPDA) dissection, accompanied by CACS.