A Study of Incidental Findings of Median Arcuate Ligament Syndrome Detected on Emergency Computed Tomography of Abdomen

Abstract

Introduction:The use of computed tomography (CT) has substantially increased in the emergency setting due to its better availability. Consequently, with increased and frequent use of CT there has been a rise in detection of number of incidental pathologies including congenital anomalies or variations. Median Arcuate Ligament Syndrome (MALS) is one such entity detected majority of the times incidentally on CT abdomen. The purpose of our study is to know the incidental finding of MALS in our University teaching hospital. Methods and Results:A retrospective review of all emergency CT abdominal scans done during the year 2015 at KLES Dr Prabhakar Kore Hospital and MRC, Belagavi was examined. There were total 135 patients who had an emergency abdominal CT scan of which 76 (56%) had some definitive pathology which can be clinically correlated with the history of patient.18 (13%) incidental findings detected, of which 4 (3%) were deemed to have MALS. Out of 4 MALS cases 2 cases were associated with other abdominal pathologies. One case was associated with pancreatitis and another case was associated with intramural hemorrhage of jejunum. Conclusion:Sometimes MALS can be associated with other abdominal pathology as detected in our study and reporting of such association will be more helpful to treating surgeons and clinicians. There is a need for larger clinico-radiological and anatomic cadaveric dissection type of studies to know the incidence of MALS in general population.