<p>Celiac plexus block as a diagnostic tool in suspected pediatric median arcuate ligament syndrome</p>

Abstract

We report the use of celiac plexus block (CPB) as a diagnostic aid in the evaluation of median arcuate ligament syndrome (MALS) in a pediatric patient. MALS is a rare cause of severe, debilitating, abdominal postprandial pain associated with nausea, vomiting, occasional diarrhea, unintentional weight loss, and abdominal bruit. MALS is a diagnosis of exclusion, after multiple investigations. This is the first case report where CPB was used to confirm candidacy for corrective surgery in the pediatric population and has served as the cornerstone in diagnosis of MALS.

Laparoscopic treatment of median arcuate ligament syndrome without ganglionectomy of the celiac plexus in the hybrid operating room: Report of a case

“…It was reported that pain relief after celiac plexus block (CPB) had been found to be a predictor of symptomatic improvement after corrective surgery [ 14 ]. Some authors reported that CPB was useful to confirm candidacy for corrective surgery of MALS [ 15 , 16 ]. In these symptomatic MALS patients, MAL release with ganglionectomy of the celiac plexus might be the best treatment.…”

Atypical Presentation of Median Arcuate Ligament Syndrome in the Emergency Department

“…Conversely, the incidence of MALS is estimated at approximately two per every 100,000 patients 10. The majority of MALS patients are relatively young women between the ages of 20–50 years old with thin body habitus who have been extensively worked up for various intra-abdominal pathology 1,6.…”

“…Once other causes have been ruled out, the diagnosis can be confirmed with imaging including duplex ultrasound, CT angiography, and magnetic resonance angiography revealing compression or stenosis of the celiac artery 6,8. Percutaneous diagnostic celiac ganglion blockade, in which lidocaine is injected into splanchnic nerves feeding into the celiac plexus, can also be performed by general surgery or IR to predict symptomatic improvement with surgical intervention 10–12…”

Neurolysis with Celiac Plexus Block for the Treatment of Median Arcuate Ligament Syndrome

“…Median arcuate ligament syndrome (MALS) is a rare (2/100,000) entity characterized by severe, debilitating, postprandial epigastric pain associated with a constellation of other vague symptoms including nausea, vomiting, occasional diarrhea, and abdominal bruit. and/or weight loss, and even leads to an abnormal aversion to food, "sitophobia" [1,2]. The classic triad of abdominal pain related to meals, weight loss, and abdominal bruit may not always present.…”