Robotic versus laparoscopic median arcuate ligament (MAL) release: a retrospective comparative study

Transcatheter arterial embolization (TAE) is the standard of care for haemodynamically-stable patients with blunt hepatic injury but it is sometimes impossible due to unfavourable vascular anatomies. This case report describes a 43-year-old male patient with abdominal pain following a motorcycle accident. Based on computed tomography (CT) findings, he was diagnosed with high-grade hepatic injury with coeliac axis stenosis (CAS) due to compression by the median arcuate ligament, and an aberrant right hepatic artery. Contrast-enhanced ultrasonography (CEUS) demonstrated multiple high echogenic tubular and ovoid structures suggestive of active bleeding within the injured liver area. Angiography revealed unique interlobar and intrahepatic collateral vessels between the right and left hepatic arteries. Liver haemorrhages were also identified. Catheterization of the feeding arteries through the collateral pathway was unsuccessful, so a decision was made to cannulate the stenotic portion of the coeliac trunk with a 5-Fr Yashiro catheter. After several attempts, the microcatheter was successfully advanced coaxially into the common hepatic artery. Embolization was performed with a 1:2 mixture of N-butyl cyanoacrylate and iodized oil. Successful haemostasis was confirmed following TAE. CEUS helped clinicians identify active bleeding following traumatic solid organ injury. TAE was a safe and effective treatment strategy. Before performing TAE, attention should be given to the presence of CAS associated with compression by the median arcuate ligament.

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Clinical outcomes of acute displaced posterior cruciate ligament tibial avulsion fracture: A retrospective comparative study between the arthroscopic suture and EndoButton fixation techniques

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2020.102798 ◽

2020 ◽

pp. 102798

Author(s):

Daohong Zhao ◽

Jia Zhong ◽

Bo Zhao ◽

Yan Li ◽

Duo Shen ◽

...

Keyword(s):

Comparative Study ◽

Posterior Cruciate Ligament ◽

Clinical Outcomes ◽

Avulsion Fracture ◽

Cruciate Ligament ◽

Tibial Avulsion Fracture ◽

Fixation Techniques ◽

Retrospective Comparative Study

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One versus two anterior miniscrews for correcting upper incisor overbite and angulation: a retrospective comparative study

Progress in Orthodontics ◽

10.1186/s40510-020-00336-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Arturo Vela-Hernández ◽

Laura Gutiérrez-Zubeldia ◽

Rocío López-García ◽

Verónica García-Sanz ◽

Vanessa Paredes-Gallardo ◽

...

Keyword(s):

Comparative Study ◽

Retrospective Comparative Study

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

Surgical Case Reports ◽

10.1186/s40792-021-01226-3 ◽

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.

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