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

2020 ◽  
Vol 54 (6) ◽  
pp. 528-531
Author(s):  
Charles J. Fox ◽  
Alex Morton ◽  
Ashlie Watters ◽  
Philip S. Mehler
Keyword(s):  
Anorexia Nervosa ◽  
Abdominal Pain ◽  
Rare Condition ◽  
Conversion Disorder ◽  
Comorbid Conditions ◽  
Successful Operation ◽  
Unique Case ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament

Median arcuate ligament syndrome (MALS) is an often discounted and vexing condition that may go unnoticed in a population of patients with complex comorbid conditions or those with poor psychiatric health. We report a unique case of a patient with anorexia nervosa in whom the successful operation for MALS was briefly complicated by a postoperative conversion disorder.

scholarly journals Median arcuate ligament syndrome and a laparoscopic coeliac trunk first approach: a literature review and a proposed algorithm

2021 ◽  
Vol 8 (10) ◽  
pp. 3160
Author(s):  
Ji Chen ◽  
Anik Sarkar ◽  
Mouhannad Jaber
Keyword(s):  
Abdominal Pain ◽  
Literature Review ◽  
Rare Condition ◽  
Recurrent Abdominal Pain ◽  
Young Female ◽  
Review Of The Literature ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Coeliac Trunk

Median arcuate ligament syndrome (MALS) is a rare condition where chronic recurrent abdominal pain is related to the compressive effects of the median arcuate ligament on the coeliac artery. The mechanism behind this phenomenon is incompletely understood but thought to be both ischemic and neuropathic in nature. As a result, the management of this condition remains controversial. Furthermore, while there have been a variety of options both radiological and interventional described for the investigation of MALS, there has yet to be a consensus in how patients exhibiting symptoms should be assessed and worked up. In this article, we described a laparoscopic coeliac trunk first approach in a young female patient and following review of the literature, propose an algorithm that can be used in the assessment and management of suspected MALS.

2762 Median Arcuate Ligament Syndrome: A Rare but Overlooked Cause of Post-Prandial Abdominal Pain

2019 ◽  
Vol 114 (1) ◽  
pp. S1526-S1527
Author(s):  
Hussam Tayel ◽  
Hesham Tayel ◽  
Sagar V. Mehta ◽  
Rodrigo Duarte-Chavez ◽  
Brian Kim ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament

scholarly journals Treatment of median arcuate ligament syndrome: outcome of laparoscopic approach

2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Julio Cezar Uili COELHO ◽  
Andréa Virmond El HOSNI ◽  
Christiano MarloPaggi CLAUS ◽  
Yan Sacha Hass AGUILERA ◽  
Gisele Pitrowsk ABOT ◽  
...  
Keyword(s):  
Weight Loss ◽  
Epigastric Pain ◽  
Clinical Manifestations ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Laparoscopic Treatment ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Operative Findings

ABSTRACT Background: Median arcuate ligament syndrome(MALS) is a rare condition thatmay cause significant clinical manifestations, including abdominal pain and weight loss. Its diagnosis may be difficult and very often delayed. The laparoscopic approach became the standard treatment of MALS. Aim: To assess the outcome of laparoscopic treatment in patients with MALS. Method: The data of sixpatients with MALS who were subjected to laparoscopic sectioning of the median arcuate ligament were retrospectively reviewed.The following data were evaluated: age, gender, clinical and diagnostic tests findings, ASA score, operative findings and complications, postoperative complications and mortality, hospital stay duration, and hospital readmission.The diagnosis of MALS was established by CT angiography and/or MR angiography. Results: There were four (66.7%) women and two (33.3%) men aged from 32 to 60 years. The main symptoms were epigastric pain (100%) and weight loss (66.7%). The findings of high-grade stenosis of the proximal celiac axis and poststenotic dilation confirmed on angiography confirmed the diagnosis in all patients. Surgical procedure was uneventful in all patients. The only postoperative complication was urinary retention that occurred in a male. At three-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic treatment of MALS is safe and effective in relieving the clinical manifestations of patients.

scholarly journals Mini-invasive treatment of median arcuate ligament syndrome, a case report

2019 ◽  
pp. 1-3
Author(s):  
Maurizio Luca ◽  
Marcodomenico Mazza
Keyword(s):  
Abdominal Pain ◽  
Therapeutic Option ◽  
Surgical Techniques ◽  
Laparoscopic Approach ◽  
Safe Procedure ◽  
Invasive Treatment ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
External Compression ◽  
Arcuate Ligament

Introduction: Median arcuate ligament syndrome (MALS), also known as Dunbar syndrome or celiac artery compression syndrome, is a rare disorder due to external compression of the celiac trunk (CT) by the median arcuate ligament (MAL). The diagnosis is difficult and often one of exclusion, because of its nonspecific symptoms that overlap with other forms of chronic intestinal ischemia. Laparoscopic approach is considered to be an optimal therapeutic option. Material and Surgical Techniques: We describe the case of a 40-year-old woman who presented with a 4 years-long clinical history of postprandial abdominal pain, occasional vomiting and severe weight loss in the last year. An abdominal CT scan demonstrated an external compression of the CT and the patient underwent laparoscopic decompression by division of the MAL. Postoperative course was uneventful and the patient was discharged on the 5th postoperative day. Discussion: Despite being MALS a rare disease, it must be kept in the differential diagnosis of abdominal pain. Diagnosis is difficult and often requires 2nd level investigations. Laparoscopy can be useful both as a diagnostic and curative approach. The laparoscopic division of the MAL is a feasible and safe procedure, leading to an improved quality of life

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