Management of median arcuate ligament syndrome: a case-based review

Abstract

Dunbar syndrome or median arcuate ligament syndrome is a rare pathology that has a great impact on the quality of life of patients. This brief report aims to present a case report of a successful treatment of Dunbar syndrome and to review the current management of this entity. We present the case of a 37 year-old patient, who was treated by median arcuate ligament laparoscopic resection. The median arcuate ligament syndrome is associated with significant morbidity. There are no diagnostic criteria established so alternative causes of abdominal pain must be excluded. Celiac artery decompression by laparoscopic approach is currently the preferred treatment. Early diagnosis and treatment of this pathology allow a significant improvement in the quality of life of patients.

Recurrent aneurysmatic bleeding of pancreaticoduodenal aneurysm due to median arcuate ligament syndrome: a case report

“…MALS, a rare condition affecting the coeliac artery, triggers symptoms due to its compression by the median arcuate ligament. These symptoms vary widely, from asymptomatic presentation to chronic abdominal pain or possible complications like aneurysm formation and retroperitoneal hemorrhage [ 1–3 ].…”

“…The characteristic hooked appearance of the celiac artery during expiration on computed tomography angiography (CTA) aids in identification. However, the diagnosis can be elusive, especially in acute scenarios [ 1 , 3 , 5 , 8 ].…”

“…Typically affecting females aged 20 to 50, it presents with postprandial epigastric pain, weight loss, and an epigastric bruit. MALS may also cause exercise-induced pain and gastroparesis causing nausea and vomiting [ 1–3 ]. While MALS is often asymptomatic and considered a benign anatomical occurrence, it can lead to life threatening complications and has been linked to true-aneurysm formation in the pancreaticoduodenal arteries [ 3–8 ].…”