scholarly journals Atypical Presentation of Median Arcuate Ligament Syndrome in the Emergency Department

2019 ◽  
Vol 3 (4) ◽  
pp. 413-416 ◽  
Author(s):  
Abby Sapadin ◽  
Ryan Misek
Keyword(s):  
Emergency Department ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Rare Condition ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Celiac Artery Compression Syndrome ◽  
Gi Symptoms ◽  
Arcuate Ligament

Celiac artery compression syndrome, also called median arcuate ligament syndrome (MALS), is a rare condition in which the diaphragmatic crura compresses the celiac axis. This results in a constellation of primarily gastrointestinal (GI) symptoms including nausea, vomiting, postprandial abdominal pain, and weight loss. It is typically a diagnosis of exclusion and may be detected via several imaging techniques including ultrasound and computed tomography angiography. We present an atypical case of MALS detected in the emergency department (ED). We review the symptomatology, diagnostic workup, and treatment options here, as well as discuss implications concerning revisits to the ED for recurrent GI symptoms.

scholarly journals Interprofessional Management of Median Arcuate Ligament Syndrome (Dunbar Syndrome) Related to Lumbar Lordosis and Hip Dysplasia: A Patient’s Perspective

2020 ◽  
Author(s):  
Sclinda Lea Janssen ◽  
Thomas Scholbach ◽  
Susan Jeno ◽  
Holte Laurie ◽  
Mandy Meyer ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Hip Dysplasia ◽  
Management Strategies ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Celiac Artery Compression Syndrome ◽  
Compression Syndrome ◽  
Arcuate Ligament ◽  
Dunbar Syndrome

We present a 53-year-old female patient with median arcuate ligament syndrome (MALS), also known as Dunbar syndrome or celiac artery compression syndrome, related to lumbar lordosis and hip dysplasia. She utilized interprofessional management strategies, which were beneficial in reducing lumbar lordosis and MALS-related symptoms. This finding is important because there are no other reports in the literature describing interprofessional strategies to manage symptoms for patients who are waiting for surgery or are not candidates for surgery.

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.

scholarly journals Celiac artery compression: Dunbar syndrome

2019 ◽  
Vol 18 ◽  
Author(s):  
Giovanna Mezzalira Santos ◽  
Luiz Marcelo Aiello Viarengo ◽  
Marcos Danillo Peixoto Oliveira
Keyword(s):  
Treatment Options ◽  
Rare Condition ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Interesting Case ◽  
Median Arcuate Ligament ◽  
Extrinsic Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Celiac Artery Compression

Abstract Celiac artery compression syndrome, also referred to as median arcuate ligament syndrome, celiac axis syndrome or Dunbar syndrome is a rare disorder consequent to extrinsic compression of the celiac trunk by the median arcuate ligament. Doppler ultrasound, multi-slice computed tomography angiography, magnetic resonance angiography, or invasive selective angiography can identify stenosis of the initial segment of the celiac artery and confirm diagnosis. Treatment options include open surgical or videolaparoscopic section of the median arcuate ligament and the fibers of the celiac plexus, or percutaneous transluminal angioplasty via an endovascular approach. We report herein an interesting case of a 38-year-old woman diagnosed with this rare condition and successfully treated with the surgical strategy.

scholarly journals Recurrent Abdominal Pain and Weight Loss in an Adolescent: Celiac Artery Compression Syndrome

2010 ◽  
Vol 24 (2) ◽  
pp. 91-93 ◽  
Author(s):  
Sarah Gander ◽  
Daniel J Mulder ◽  
Sarah Jones ◽  
John D Ricketts ◽  
Don A Soboleski ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Imaging Techniques ◽  
Recurrent Abdominal Pain ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Celiac Artery Compression Syndrome ◽  
Compression Syndrome ◽  
Arcuate Ligament ◽  
Celiac Artery Compression

Celiac artery compression syndrome is a rare cause of abdominal pain and weight loss, likely caused by compression of the celiac artery or plexus by the median arcuate ligament. A case of celiac artery compression syndrome in a 17-year-old male patient with severe postprandial pain and weight loss is described. Imaging techniques such as computed tomography, angiography and Doppler ultrasound identified the abnormality, which was corrected by laparoscopic surgery.

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 Median Arcuate Ligament Syndrome: An Exceptional Cause of Abdominal Pain

2021 ◽  
Vol 5 (4) ◽  
pp. 177-179
Author(s):  
Satilmis Bilgin ◽  
◽  
Gulali Aktas ◽  
Ozge Kurtkulagi ◽  
Tuba Taslamacioglu Duman ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Weight Loss ◽  
Abdominal Pain ◽  
Laparoscopic Surgery ◽  
Treatment Options ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Artery Disease

Abstract: Median Arcuate Ligament Syndrome (MALS) is caused by the compression of celiac artery by median arcuate ligament and may cause serious symptoms; such as abdominal pain and weight loss. Here we present a 56 year old man with MALS, whom suffered of postprandial abdominal pain, weight loss, nausea and vomiting. Laparoscopic surgery revealed his symptoms after MALS diagnosis was established. In conclusion, MALS should be considered in the differential diagnosis of patients with complaints of postprandial abdominal pain, nausea and weight loss. Laparoscopic surgery could be as successful as other treatment options in these patients. Keywords: Median arcuate ligament syndrome, Postprandial abdominal pain, Laparoscopic surgery, Nausea, Celiac disease, Coronary artery disease.

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

Assessment of celiac artery compression using color-coded duplex sonography

2020 ◽  
Vol 76 (3) ◽  
pp. 413-423 ◽  
Author(s):  
Claudia Römer ◽  
Thomas Fischer ◽  
Oliver Haase ◽  
Martin Möckel ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Peak Systolic Velocity ◽  
Rare Condition ◽  
Diagnostic Value ◽  
Celiac Artery ◽  
Breath Hold ◽  
Median Arcuate Ligament ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Arcuate Ligament

BACKGROUND: Median arcuate ligament syndrome (MALS) is a rare condition due to compression of the celiac artery (CA) by an anatomically abnormal median arcuate ligament. With ultrasonography (US) as first-line diagnostic modality in patients with unclear abdominal pain, there is limited data on its diagnostic performance in MALS. OBJECTIVE: To investigate the value of CA peak systolic velocity (PSV) in the workup of patients with suspected MALS. METHODS: Patients with diagnosis of MALS between 2009 and 2019 were referred by Department of Visceral Surgery after clinical and gastroenterological workup. Diagnosis was confirmed by surgery or further cross-sectional imaging. B-mode US findings and PSV in the CA during various respiratory states were compared between patients with a final MALS diagnosis and patients not meeting the diagnostic criteria. RESULTS: Patients with proven MALS (n = 10) had higher median CA PSV during normal inspiratory breath-hold (239 [IQR, 159–327] vs. 138 [IQR, 116–152] cm/s; p < #x003C;< #x200A;0.001), and expiratory breath-hold (287 [IQR, 191–412] vs. 133 [IQR, 115–194] cm/s; p < #x003C;< #x200A;0.001) compared to patients without MALS (n = 26). CA PSV in both inspiratory breath-hold (AUC 0.88, 95% CI 0.77–1.00) and expiratory breath-hold (AUC 0.89, 95% CI 0.78–1.00) was of diagnostic value for confirming MALS. The best diagnostic performance (100% sensitivity, 80% specificity) was found for the combination of CA PSVexpiration + 2.4 · PSVinspiration > 550 cm/s . CONCLUSIONS: Since results on optimal cutoff values are inconsistent, a combination of CA PSVs during breathing maneuvers may help to diagnose or rule out MALS.

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