scholarly journals A man with the rare simultaneous combination of three abdominal vascular compression syndromes: median arcuate ligament syndrome, superior mesenteric artery syndrome, and nutcracker syndrome

2021 ◽  
Vol 16 (6) ◽  
pp. 1264-1270
Author(s):  
Renato Farina ◽  
Cecilia Gozzo ◽  
Pietro Valerio Foti ◽  
Andrea Conti ◽  
Tiziana Vasile ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Superior Mesenteric Artery Syndrome ◽  
Vascular Compression ◽  
Nutcracker Syndrome ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Compression Syndromes

scholarly journals Laparoscopic treatment in a patient with median arcuate ligament syndrome identified at the onset of superior mesenteric artery dissection: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Haruhiko Okada ◽  
Kazuhisa Ehara ◽  
Hisashi Ro ◽  
Masaki Yamada ◽  
Tetsuya Saito ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Intraoperative Complications ◽  
Laparoscopic Approach ◽  
Celiac Axis ◽  
Artery Dissection ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Extrinsic Compression ◽  
Arcuate Ligament

Abstract Background Median arcuate ligament syndrome (MALS) is a rare clinical entity caused mainly by extrinsic compression of the celiac axis by the median arcuate ligament (MAL). Severe celiac artery stenosis can lead to the development of collateral circulation, aneurysms, and, rarely, superior mesenteric artery (SMA) dissection. The treatment of MALS involves the surgical release of the MAL. However, a standard procedure with the use of laparoscopy has not been established, and intraoperative complications can lead to severe vascular injury. Case presentation The patient was a 43-year-old man with MALS identified at the onset of SMA dissection. After treatment for the SMA dissection, he underwent laparoscopic MAL release. Using the technique of laparoscopic gastrectomy within the surgical field, we performed laparoscopic MAL release and ganglionectomy safely with a good view. Immediate symptomatic improvement was acquired, and no recurrence was observed at the 20-month follow-up. Conclusion We reported a rare case of MALS and SMA dissection. A horizontal 3D laparoscopic approach of the celiac axis allows for safe, meticulous, and radical MAL release and ganglionectomy.

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.

scholarly journals The Roles of Celiac Trunk Angle and Vertebral Origin in Median Arcuate Ligament Syndrome

Diagnostics ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 76
Author(s):  
Ryan P. Dyches ◽  
Kelsey J. Eaton ◽  
Heather F. Smith
Keyword(s):  
Mesenteric Artery ◽  
Anatomical Variation ◽  
Gastrointestinal Symptoms ◽  
Celiac Trunk ◽  
Clinical Implications ◽  
Vertebral Level ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Flow Through

Median arcuate ligament syndrome (MALS) is a rarely diagnosed condition resulting from compression of the celiac trunk (CT) by the median arcuate ligament (MAL) of the diaphragm. Ischemia due to reduced blood flow through the CT and/or neuropathic pain resulting from celiac ganglion compression may result in a range of gastrointestinal symptoms, including nausea, postprandial discomfort, and weight loss. However, the mechanism of compression and its anatomical correlates have been incompletely delineated. It has been hypothesized that CT angle of origination may be more acute in individuals with MALS. Here, frequency of anatomical variation in the MAL and CT were assessed in 35 cadaveric subjects (17M/18F), including the vertebral level of origin of CT and superior mesenteric artery (SMA), the distance between CT and MAL and SMA, the angles of origination of CT and SMA, the diameter at the CT base, and MAL/CT overlap. Females exhibited significantly higher rates of inferred MAL/CT overlap than males. Significant correlations were revealed between MAL/CT overlap and angles of origination of the CT and SMA. Vertebral level of origin of the CT in individuals with MAL/CT overlap was not significantly more superior than in those without. This study also revealed a significant relationship between MAL/CT overlap and angle of origination of the CT, which has clinical implications for understanding the anatomy associated with MALS.

scholarly journals Nutcracker Syndrome Accompanying With Superior Mesenteric Artery Syndrome: A Case Report

2019 ◽  
Vol 12 ◽  
pp. 117954761985538
Author(s):  
Nabil A Al-Zoubi
Keyword(s):  
Case Report ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Past History ◽  
Left Renal Vein ◽  
Superior Mesenteric Artery Syndrome ◽  
Uneventful Recovery ◽  
Nutcracker Syndrome ◽  
Ct Angiogram ◽  
Renal Nutcracker Syndrome

Purpose: The duodenum and the left renal vein (LRV) occupy the vascular angle made by the superior mesenteric artery (SMA) and the aorta. When the angle becomes too acute, compression of either structure can occur. Although superior mesenteric artery syndrome (SMAS) and renal Nutcracker syndrome (NCS) share the same pathogenesis, concurrent development has rarely been reported. Case report: A 38-year-old female patient with a past history of gastrojejunostomy operated 6 years ago due to SMAS. She referred to vascular clinic with sever intermittent left-sided loin pain during the last 6 years. Computed tomography (CT)-angiogram and selective LRV angiogram with pressure gradient confirmed the diagnosis of NCS. She was treated by LRV transposition with uneventful recovery and considerable relief of symptoms. Conclusions: NCS accompanying with SMAS is quite unusual. A patient, who first presents with clinical evidence of SMAS, could also simultaneously or sometime thereafter present with NCS and vice versa.

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