Median arcuate ligament syndrome: vascular surgical therapy and follow-up of 18 patients

2009 ◽  
Vol 394 (6) ◽  
pp. 1085-1092 ◽  
Author(s):  
Dirk Grotemeyer ◽  
Mansur Duran ◽  
Franziska Iskandar ◽  
Dirk Blondin ◽  
Kim Nguyen ◽  
...  
Keyword(s):  
Surgical Therapy ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament

Laparoscopic treatment of rare median arcuate ligament syndrome – medium-term follow-up

2021 ◽  
Vol 93 (SUPLEMENT) ◽  
pp. 1-5
Author(s):  
Natalia Dowgiałło-Gornowicz ◽  
Weronika Grochowska ◽  
Paweł Lech ◽  
Sławomir Saluk ◽  
Maciej Michalik
Keyword(s):  
Computed Tomography ◽  
Computed Tomography Angiography ◽  
Celiac Axis ◽  
Complete Relief ◽  
Laparoscopic Treatment ◽  
Medium Term ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament

The paper "Laparoscopic treatment of the rare median arcuate ligament syndrome - mid-term follow-up" is important because the results of treatment are based not only on the subjective feelings of patients, but also on objective imaging tests, which is not observed in the previously published works on this topic. SUMMARY Introduction Median arcuate ligament syndrome [MALS] is a rare cause of chronic epigastric pain. The presentation might be unclear and non-specific. Diagnosing the syndrome requires interdisciplinary methods and specialists. Treatments consist of celiac axis release performed laparoscopically or robotically, and intraluminal stenting. The aim of the study was to report the medium-term postoperative follow-up results for four patients with MALS. Material and methods We performed 5 laparoscopic celiac axis releases in patients with MALS in our department in 2018. We included 4 patients in this study and all patients were admitted 16-23 months after the surgery for computed tomography angiography. Results Patients constituted 4 women aged 28-63 years with a mean body mass index of 22.4 kg/m2. The diagnosis of MALS was confirmed by computed tomography angiography, which showed severe (> 70%) narrowing of the celiac axis. Patients underwent laparoscopic celiac axis release, and all patients were discharged on the first postoperative day with no postoperative complications. Patients improved quality of life and complete relief of symptoms. Follow-up computed tomography angiography confirmed full decompression of the celiac axis in all four patients, with no stenosis caused by scarification of the celiac axis. Conclusions Laparoscopy is a valuable and safe method to treat patients with MALS. Keywords: Dunbar syndrome, median arcuate ligament syndrome, laparoscopy, MALS, digestive surgery

scholarly journals Dunbar syndrome: a rare presentation of abdominal angina treated by revascularization of the celiac artery by endovascular stenting

2018 ◽  
Vol 6 (6) ◽  
pp. 2169 ◽  
Author(s):  
Rakshith Shetty ◽  
K. Subramanyam ◽  
Chinthu Sara Jacob
Keyword(s):  
Epigastric Pain ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Rare Presentation ◽  
Extrinsic Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome

Median arcuate ligament syndrome (MALS) is a rare entity characterized by extrinsic compression of the celiac artery and symptoms of postprandial epigastric pain, nausea, vomiting, and weight loss mimicking mesenteric ischemia. The following case illustrates a rare cause of abdominal pain, where this young woman was found to have celiac trunk stenosis , secondary to compression of the trunk by the median arcuate ligament. She underwent a successful stenting to the ostial celiac trunk, thus reliving her symptomatically. Decompression of the celiac artery is the general approach. Usually post PTA, once revascularisation is achieved, 75% of the patients remain asymptomatic at follow up.

scholarly journals Laparoscopic treatment for celiac artery stenosis caused by median arcuate ligament compression with Adachi V type vascular anomaly: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiroshi Saito ◽  
Koichiro Sawada ◽  
Jyunichi Ogawa ◽  
Masashi Hashimoto ◽  
Masahiro Oshima ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Vascular Anomaly ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Laparoscopic Treatment ◽  
Median Arcuate Ligament ◽  
Case Presentation ◽  
Arcuate Ligament ◽  
Major Vascular Injury

Abstract Background Median arcuate ligament syndrome (MALS), which results from compression of the median arcuate ligament (MAL), is a rare cause of abdominal pain and weight loss. Treatment is dissection of the MAL; however, the laparoscopic procedure is not yet established and it involves the risk of major vascular injury, especially in cases with an anomaly. Case presentation A 47-year-old man was evaluated at the hospital for epigastric pain. Contrast computed tomography scan revealed stenosis of the celiac artery origin due to the MAL. An Adachi V type vascular anomaly was also observed. Laparoscopic treatment was performed to release pressure on the celiac artery. Laparoscopic ultrasonography was used to less invasively confirm the release of the MAL. Despite a concomitant Adachi V type vascular anomaly, surgery was safely performed using the laparoscopic magnification view and intraoperative ultrasonography. Follow-up ultrasonography confirmed the celiac artery stenosis has not recurred. Conclusions A rare case of MALS with an Adachi V type vascular anomaly is presented and the laparoscopic treatment is detailed.

Detailed anatomy and procedure of celiac artery decompression in median arcuate ligament syndrome

2021 ◽  
Author(s):  
Kyoji Ito ◽  
Nobuyuki Takemura ◽  
Ryo Oikawa ◽  
Fuyuki Inagaki ◽  
Fuminori Mihara ◽  
...  
Keyword(s):  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament

scholarly journals IP243 Outcomes of Celiac Decompression in a Cohort of Patients With Median Arcuate Ligament Syndrome

2017 ◽  
Vol 65 (6) ◽  
pp. 120S
Author(s):  
Bernardino C. Branco ◽  
Jayer Chung ◽  
Ramyar Gilani ◽  
Miguel Monter-Baker ◽  
Joseph Mills ◽  
...  
Keyword(s):  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament

Dunbar (Or Median Arcuate Ligament) Syndrome: A Case Series

2021 ◽  
Vol 23 (09) ◽  
pp. 450-459
Author(s):  
Dr Praveen K Sharma, MD RD ◽  
◽  
Dr. Pavankumar mathapati ◽  
Dr. Dinesh babu J ◽  
Dr. Keerthi vatsan ◽  
...  
Keyword(s):  
Case Series ◽  
Vascular Reconstruction ◽  
Vascular Compression ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Non Invasive ◽  
Compression Syndrome ◽  
Axis Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome

Dunbar syndrome (DS) (or Median arcuate ligament syndrome) is a rare entity of the vascular compression syndrome, where there is focal proximal coeliac axis compression by Median arcuate ligament (MAL). It results in an insufficient supply of blood to the respective organs of the gastrointestinal tract (GIT). Multi-detector computed tomography (MDCT) is a very convenient non-invasive modality in diagnosing this condition and helpful in distinguishing it from other conditions, such as atherosclerotic disease. DS can further be treated disorder surgically by relieving the compression and sometimes may need vascular reconstruction. We present five cases of the DS.

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