scholarly journals Median Arcuate Ligament Syndrome: A Case Report

2018 ◽  
Vol 21 (2) ◽  
pp. 38-39
Author(s):  
Akash Chitrakar ◽  
Nirajan Subedi ◽  
Ramesh Singh Bhandari
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Epigastric Pain ◽  
Celiac Artery ◽  
Celiac Axis ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Celiac Ganglion ◽  
Extrinsic Compression ◽  
Arcuate Ligament

Median arcuate ligament (MAL) syndrome results from extrinsic compression of the celiac axis and or celiac ganglion by the MAL and diaphragmatic crura. A seventy five years lady presented with post prandial epigastric pain for 6 months. She had undergone considerable investigations for other diagnoses before an abdominal computed tomography (CT) revealed median arcuate ligament impinging celiac artery at its origin. She successfully underwent laparotomy and release of median arcuate ligament.  

scholarly journals Median arcuate ligament syndrome presenting with unintentional weight loss and epigastric pain

2019 ◽  
Vol 6 (10) ◽  
pp. 3839
Author(s):  
Mohammed Taher Mujahid ◽  
Virendra Kumar Soni ◽  
Rahul Saini
Keyword(s):  
Weight Loss ◽  
Rare Case ◽  
Surgical Intervention ◽  
Epigastric Pain ◽  
Rare Condition ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Extrinsic Compression ◽  
Arcuate Ligament

Median arcuate ligament syndrome is a rare condition characterized by extrinsic compression of celiac artery and celiac plexus by the median arcuate ligament. Patients typically present with chronic postprandial pain, nausea and occasionally, vomiting and weight loss. Treatment of this syndrome is laparoscopic or open surgical release of median arcuate ligament and gangliectomy. We report a rare case of median arcuate ligament syndrome in a patient who presented with abdominal pain and nausea. The patient was evaluated, investigated and planned for surgical intervention but the patient refused for treatment.

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 Robotic approach to treat Median Arcuate Ligament syndrome: a case report

2020 ◽  
Vol 2020 (5) ◽  
Author(s):  
Roberto Bustos ◽  
Michail Papamichail ◽  
Alberto Mangano ◽  
Valentina Valle ◽  
Pier Cristoforo Giulianotti
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Epigastric Pain ◽  
Celiac Trunk ◽  
Robotic Approach ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Clinical Diagnostic ◽  
Arcuate Ligament ◽  
History Of

Abstract The Median Arcuate Ligament (MAL) syndrome is the symptomatic compression of the celiac trunk by the MAL and other ganglionic periaortic tissue. Despite its rarity, this condition is significant from a clinical, diagnostic and management standpoint and it is usually a diagnosis of exclusion. A 61-year-old female with history of intermittent postprandial epigastric pain was diagnosed with MAL syndrome during CT scan imaging (no other causes of pain were identified). Patient successfully underwent robotic MAL release with symptoms improvement after surgery. The robotic approach is feasible and may allow a very precise and delicate dissection with release of the MAL.

scholarly journals A dangerous surgical masquerade - medial arcuate ligament syndrome as acute coronary syndrome: a case report

2020 ◽  
Vol 7 (6) ◽  
pp. 2016
Author(s):  
Preethi Subramanian ◽  
Rajan Vaithianathan
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Chest Pain ◽  
Celiac Artery ◽  
Sudden Onset ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Coronary Syndrome ◽  
Arcuate Ligament ◽  
Focal Stenosis

Median arcuate ligament syndrome is an uncommon cause for abdominal pain and weight loss, caused by median arcuate ligament compressing the celiac plexus or artery. Median arcuate ligament is the continuation of the posterior diaphragm which passes superior to celiac artery and surrounds the aorta. In this case report, A 67 year old male presented with complaints of sudden onset chest pain and loss of weight for the past 6 months. CECT thorax and abdomen it showed features of focal stenosis of coeliac axis and post stenotic dilation of the coeliac trunk suggesting median arcuate ligament syndrome. Laparoscopic median arcuate ligament release was done to relieve the patient from symptoms. Diagnosis of median arcuate ligament syndrome should be considered in a patient presenting with chest pain and weight loss with normal cardiac status and unexplained etiology.

scholarly journals Median Arcuate Ligament Syndrome

2018 ◽  
Vol 35 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Evelyn Wu
Keyword(s):  
Epigastric Pain ◽  
Celiac Artery ◽  
Chronic Mesenteric Ischemia ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Celiac Artery Compression Syndrome ◽  
Compression Syndrome ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Abdominal Bruit

Median arcuate ligament syndrome (MALS) is a condition characterized by pain in the abdominal region attributed to compression of the celiac artery by the median arcuate ligament of the diaphragm during expiration. MALS is also known as celiac artery compression syndrome, celiac axis syndrome, or Dunbar syndrome. Pain may result from the tight pressing on the celiac nerves in the area. The patient usually presents with symptoms such as postprandial epigastric pain, weight loss, and, occasionally, an abdominal bruit. Furthermore, some individuals may experience nausea and vomiting. It may be an etiology of a rare disorder, chronic mesenteric ischemia.

Celiac Artery Dissection and Retroperitoneal Hemorrhage in Median Arcuate Ligament Syndrome Treated With a Stent and Transcatheter Arterial Embolization: Preprocedural 4-Dimensional Computed Tomography Angiography Assessment

2021 ◽  
pp. 153857442110287
Author(s):  
Atsushi Saiga ◽  
Jun Koizumi ◽  
Koji Osumi ◽  
Joji Ota ◽  
Yoshihiro Kubota ◽  
...  
Keyword(s):  
False Lumen ◽  
Celiac Artery ◽  
Celiac Axis ◽  
Artery Dissection ◽  
True Lumen ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Retroperitoneal Hemorrhage ◽  
Celiac Axis Stenosis ◽  
Arcuate Ligament

A 61-year-old man presented with retroperitoneal hemorrhage caused by an aneurysm rupture of the pancreaticoduodenal arcade (PDA), and acute celiac artery dissection distal to celiac axis stenosis. Owing to the gradual growth of the false lumen, we planned to deploy a stent to the celiac artery dissection and embolize the PDA aneurysm. Prior to stent placement, we assessed the acute celiac artery dissection distal to the stenosis using four-dimensional computed tomography (CT) angiography through expiration/inspiration/expiration cycle. We diagnosed median arcuate ligament syndrome considering that the celiac axis showed a hooked narrowing at end-expiration, and the compression decreased at end-inspiration. Additionally, the true lumen distal to the stretched axis dilated in the inspiration phase. Therefore, we could advance a catheter into the true lumen during inspiration and successfully deploy a stent. Subsequently, laparoscopic median arcuate ligament release was performed after the stent deployment. A postoperative CT scan showed good patency in the stent, with disappearance of the blood filling the false lumen and with reduced celiac axis stenosis.

scholarly journals Intraoperative trans-esophageal echographic evaluation of the celiac artery flow after arcuate ligament resection in a case of Dunbar Syndrome. A case report

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Giacomo Coppalini ◽  
◽  
Enrico Giustiniano ◽  
Fulvio Nisi ◽  
Carlo Castoro ◽  
...  
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Rare Disease ◽  
Epigastric Pain ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Artery Flow

Dunbar Syndrome (DS), also known as Median Arcuate Ligament (MAL) syndrome, is a rare disease in which the celiac trunk is compressed by a fibrous attachment at the diaphragmatic crura causing abdominal angina with a large spectrum of symptoms including nausea, vomiting, weight loss, and postprandial epigastric pain.

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 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.

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