scholarly journals New perspective on median arcuate ligament syndrome. Case reports

2021 ◽  
Vol 21 (86) ◽  
pp. e234-e236
Author(s):  
Andrzej Smereczyński ◽  
◽  
Katarzyna Kołaczyk ◽  
Radosław Kiedrowicz ◽  
◽  
...  
Keyword(s):  
Collateral Circulation ◽  
Case Reports ◽  
Causative Factor ◽  
Standing Position ◽  
Left Lobe ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Coeliac Trunk ◽  
New Perspective

A large group of patients with significant asymptomatic or low-symptomatic coeliac trunk stenosis require deeper consideration. On angiography, CT and MRI, 10–24% of examined patients are found to have their coeliac trunk compressed by the median arcuate ligament of the diaphragm. The associated median arcuate ligament syndrome, which is also called coeliac trunk compression syndrome or Dunbar syndrome, is rarely fully symptomatic. It is estimated that there are up to 7% of patients with such a clinical presentation. An asymptomatic or low-symptomatic course of the disease in patients with the syndrome is mainly explained by a developed collateral circulation, particularly involving the arterial arcades of the head of pancreas. In such cases, CT angiography detects collateral circulation in 22–69.6% of examined patients. The present authors often observed coeliac trunk blood flow to normalise in a standing position. According to them, the main causative factor for this phenomenon is the deflection of the coeliac trunk and its compression against the aorta by a lowered left lobe of the liver. The researchers observed it in many individuals; in this study, 5 cases are presented.

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.

scholarly journals Spontaneous bleeding of the inferior pancreatic-duodenal artery in median arcuate ligament syndrome: do not miss the diagnosis

2019 ◽  
Vol 2019 (7) ◽  
Author(s):  
Eleni Rebelos ◽  
Alessandro Cipriano ◽  
Laura Ferrini ◽  
Silvia Trifirò ◽  
Niccolò Napoli ◽  
...  
Keyword(s):  
Color Doppler ◽  
Rare Condition ◽  
University Hospital ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Spontaneous Bleeding ◽  
Abdominal Ultrasonography ◽  
Luminal Narrowing ◽  
Arcuate Ligament ◽  
Coeliac Trunk

Abstract Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament (MAL) causes compression of the coeliac trunk. The chronic compression leads to coeliac trunk luminal narrowing and reduced blood supply to the abdominal splanchnic organs with possible local complications such as pseudo-aneurysms and spontaneous bleeding. Its incidence is probably underestimated due to the poor availability of color Doppler ultrasonography (CD-US), especially in an Emergency Department (ED) setting. A 44-year old woman presented to Pisa University Hospital ED with acute abdominal pain. An abdominal ultrasonography scan (US scan) was performed showing the presence of free liquid in the Douglas pouch. The abdominal computed tomography scan (CT scan) highlighted the presence of a large mesenteric hematoma. A CD-US revealed a significant stenosis of the coeliac artery. A selective angiography confirmed the diagnosis of MALS with a pseudo-aneurysm of the inferior pancreatic-duodenal artery, which was successfully embolized.

scholarly journals Laparoscopic decompression as treatment for median arcuate ligament syndrome

2015 ◽  
Vol 97 (6) ◽  
pp. e96-e99 ◽  
Author(s):  
M Rubinkiewicz ◽  
PK Ramakrishnan ◽  
BM Henry ◽  
J Roy ◽  
A Budzyski
Keyword(s):  
Epigastric Pain ◽  
Treatment Options ◽  
Recurrent Abdominal Pain ◽  
Resonance Imaging ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Coeliac Trunk ◽  
Abdominal Bruit ◽  
Pain Patients

Median arcuate ligament syndrome (MALS) is a rare disorder due to coeliac trunk compression by the median arcuate ligament, resulting in coeliac artery stenosis characterised by chronic, recurrent abdominal pain. Patients with MALS are often middle-aged females presenting with a triad of postprandial epigastric pain, weight loss and abdominal bruit. It is a diagnosis of exclusion and confirmed by computed tomography or magnetic resonance imaging. Laparoscopic or open surgical decompression are the only treatment options in MALS. We present two cases of MALS treated by laparoscopic decompression as well as a literature review on this treatment.

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.

scholarly journals Laparoscopic treatment of median arcuate ligament syndrome in a 16-year-old male

2018 ◽  
Vol 52 ◽  
pp. 79-83 ◽  
Author(s):  
Yoshinori Fujiwara ◽  
Masaharu Higashida ◽  
Hisako Kubota ◽  
Yusakua Watanabe ◽  
Michi Ueno ◽  
...  
Keyword(s):  
Laparoscopic Treatment ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament
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