Outcome predictors in median arcuate ligament syndrome

Abstract

MALS was more likely to respond to decompression if patients had postexertional pain. Patients who presented with vomiting and unprovoked pain were unlikely to respond to surgery. In contrast with previous studies, postprandial pain was not found to be predictive of outcome.

Factors Associated with Symptomology of Celiac Artery Compression and Outcomes following Median Arcuate Ligament Release

“…This finding is compatible with previous reports of MALS being more commonly diagnosed in younger populations. 18,19 Furthermore, a study done by Ho et al 13 also reported a prevalence of 40% (17/43) MALS patients with prior abdominal surgery. We hypothesize that prior abdominal operation may somehow provoke chronic inflammation or nerve irritation causing fibrosis of the ligament and hypertrophy of the nerve fiber as histologically presented in the study by Klimas et al 19 A similar cellular mechanism causing postsurgical adhesions following abdominal surgery may be one of the hypotheses.…”

“…Literature has shown that the majority of patients achieved symptom resolution following surgical release 11 ; however, instances of recurrence or refractory symptoms were not rare, either. 12,13 In the current study, we utilized the imaging database of a high-volume institution with a long history of receiving MALS referrals to identify the risk factors for MALS among patients with radiographic CAC. In addition, we sought to examine factors associated with worse outcomes among symptomatic MALS patients who underwent MAL release.…”

An unusual cause of epigastric pain and diaphoresis

“…When present, symptoms usually manifest postprandially. In the presence of persistent symptomatology, treatment usually involves surgical release of the median arcuate ligament [8,9] with minimal mortality, but variable outcome in terms of symptom relief [10]. Significant symptomatology prior to surgery appears to be associated with better response to treatment [11].…”

Abdominal Pain Associated With Anorexia Nervosa and Median Arcuate Ligament Syndrome: A Rare Condition Shadowed by a Postoperative Conversion Disorder

“…1,2 The syndrome is characterized by chronic severe postprandial abdominal pain, nausea, vomiting, and weight loss that may range from mild to severe and has led to much controversy regarding its clinical existence and optimal management. [3][4][5][6] The debate is perpetuated by the finding of extrinsic celiac compression in both autopsy studies and celiac angiography in asymptomatic patients. 2 Ultimately, mixed enthusiasm for surgical treatment in patients with this condition continues to exist, especially in those confounded by other comorbid conditions.…”