Median Arcuate Ligament Syndrome With Celiac Artery Aneurysm and Dissection

Abstract

<jats:p> Median arcuate ligament syndrome (MALS) is the chronic symptomatic compression of the celiac artery by the median arcuate ligament. A known potential sequela of MALS is celiac artery aneurysm, which could predispose the diseased artery to dissection. However, the presence of celiac artery dissection and MALS is yet to be reported. Here, we present a case of MALS with a coincident celiac artery aneurysm and dissection. </jats:p>

Major vascular and pancreatic penetrating trauma in patient with pre-existing MALS

“…This increased flow through collateral arteries has been hypothesized to cause secondary aneurisms which can lead to severe bleeding. In these cases, treatment of the aneurisms and the MALS is indicated [6] , [7] . The MALS condition in this case had to be managed operatively in order to re-establish arterial blood supply to the liver as the GDA, responsible for liver blood flow, had to be sacrificed due to the AP fistula.…”

A Median Arcuate Ligament Syndrome Could Be Re-termed as a Nutcracker Celiac Ganglion Abdominal Pain Syndrome

“…There was a study that analyzed the compression of blood vessels into the radiological image to see if there was post-stenotic dilatation or not, but it was not clinically meaningful. 15 There were studies by surgeons with different ideas on surgical correction, 16 , 17 but it was questioned why many physicians do not consider MALS as a differential diagnosis in patients with chronic abdominal pain of unknown cause. We thought that the characteristics of the pain in these patients are important and the mechanism of the pain is eventually the compression of the celiac trunk ganglion by medical arcuate ligament based on our case series.…”

Celiac Artery Dissection and Retroperitoneal Hemorrhage in Median Arcuate Ligament Syndrome Treated With a Stent and Transcatheter Arterial Embolization: Preprocedural 4-Dimensional Computed Tomography Angiography Assessment

“…Although median arcuate ligament syndrome (MALS) sometimes caused pancreaticoduodenal arcade (PDA) aneurysms and retroperitoneal hemorrhage due to the rupture of the aneurysms, MALS with a coincident celiac artery dissection is very rare. 1,2 Moreover, there are no reports addressing stent deployment for celiac artery dissection in case of MALS. Before we deployed the stent, we performed four-dimensional (4D) computed tomography (CT) angiography for the evaluation of MALS and the celiac artery dissection.…”