Median arcuate ligament syndrome

Ng, FH; Wai, Ophelia Ka Heng; Wong, Agnes W.; Yu, SM

doi:10.12809/hkmj154821

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…It may cause various clinicalsymptoms such as abdominal pain, weight loss, nausea and vomiting, and diarrhea. The pain isvariable and it may be mainly postprandial and alleviated by leaning the body forward [11][12][13][14] .In athletes, the pain may be exercise-induced rather than postprandial 7 . Epigastric bruit may be recognized during physical examination.…”

mentioning

confidence: 99%

Treatment of median arcuate ligament syndrome: outcome of laparoscopic approach

Coelho

Hosni

Claus

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: Median arcuate ligament syndrome(MALS) is a rare condition thatmay cause significant clinical manifestations, including abdominal pain and weight loss. Its diagnosis may be difficult and very often delayed. The laparoscopic approach became the standard treatment of MALS. Aim: To assess the outcome of laparoscopic treatment in patients with MALS. Method: The data of sixpatients with MALS who were subjected to laparoscopic sectioning of the median arcuate ligament were retrospectively reviewed.The following data were evaluated: age, gender, clinical and diagnostic tests findings, ASA score, operative findings and complications, postoperative complications and mortality, hospital stay duration, and hospital readmission.The diagnosis of MALS was established by CT angiography and/or MR angiography. Results: There were four (66.7%) women and two (33.3%) men aged from 32 to 60 years. The main symptoms were epigastric pain (100%) and weight loss (66.7%). The findings of high-grade stenosis of the proximal celiac axis and poststenotic dilation confirmed on angiography confirmed the diagnosis in all patients. Surgical procedure was uneventful in all patients. The only postoperative complication was urinary retention that occurred in a male. At three-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic treatment of MALS is safe and effective in relieving the clinical manifestations of patients.

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mentioning

confidence: 99%

Treatment of median arcuate ligament syndrome: outcome of laparoscopic approach

Coelho

Hosni

Claus

et al. 2020

ABCD, arq. bras. cir. dig.

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“…[ 22 ] Severe complications such as ruptured pseudoaneurysm of the inferior pancreaticoduodenal artery have also been reported. [ 23 24 ] In our study, one of the patients developed ileus and the other patients developed pulmonary thromboembolism after surgery.…”

Section: Discussionmentioning

confidence: 57%

Median arcuate ligament (Dunbar) syndrome

Kafadar

Oğuz

Aday

et al. 2021

Journal of Minimal Access Surgery

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Background: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. Aim: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. Materials and Methods: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. Results: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 ± 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120–200) and intra-operative blood loss was 150 ml (100–250). Length of stay was 3.1 day (2–9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results.

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“…2,10,11 Another criterion to diagnose MALS is a PSV ratio greater than 3:1 in the celiac artery during expiration compared with the PSV in the abdominal aorta under the diaphragm. 12 Sagittal view of CTA identifies a characteristic focal narrowing of the celiac artery exacerbated during the expiratory phase; 13 the hooked appearance with the absence of arterial calcifications differentiate this condition from atherosclerotic disease, main causes of celiac artery narrowing. 7,14 MRA can also be used in patients with allergy to iodinated contrast media and with results similar to CTA.…”

Section: Discussionmentioning

confidence: 99%

Median arcuate ligament syndrome, a rare case of chronic abdominal pain

et al. 2018

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The median arcuate ligament syndrome (MALS) is a rare disease characterized by abdominal pain caused by the external compression of the celiac artery by the median arcuate ligament. Surgical treatment is indicated, but given the non-specific symptoms, these patients are often hospitalized in the Departments of Internal Medicine where the diagnosis may be unknown. We present a case of MALS admitted to our Internal Medicine Division. An abdominal ultrasound in a woman with longstanding abdominal pain showed elevated celiac artery velocities during forced expiration. Computed tomography angiography (CTA) of the abdomen showed stenosis of the origin of the celiac artery and confirmed the diagnosis of MALS. MALS is a syndrome that has to be considered, especially in young women with abdominal pain of unclear etiology; evaluated by color Doppler ultrasound, in the presence of elevated hepatic artery velocities during forced expiration, the confirmatory test is CTA.

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Median arcuate ligament syndrome

Cited by 6 publications

References 3 publications

Treatment of median arcuate ligament syndrome: outcome of laparoscopic approach

Treatment of median arcuate ligament syndrome: outcome of laparoscopic approach

Median arcuate ligament (Dunbar) syndrome

Median arcuate ligament syndrome, a rare case of chronic abdominal pain

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