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Median arcuate ligament

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https://www.readbyqxmd.com/read/29923979/median-arcuate-ligament-syndrome-and-arterial-anastomotic-bleeding-inducing-hepatic-artery-thrombosis-after-liver-transplantation-a-case-report
#1
Xiaodong Sun, Zhongqi Fan, Wei Qiu, Yuguo Chen, Chao Jiang, Guoyue Lv
RATIONALE: Median arcuate ligament (MAL) may compress the coeliac trunk inducing median arcuate ligament syndrome (MALS). MALS is a risk factor for hepatic artery thrombosis (HAT) in liver transplant recipients. PATIENT CONCERNS: A thin female complained about upper abdominal pain for two months. DIAGNOSES: The patient was diagnosed as primary biliary cirrhosis. INTERVENTIONS: The patient received two liver transplantations...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29914831/prevalence-of-signs-of-celiac-axis-compression-by-the-median-arcuate-ligament-on-computed-tomography-angiography-in-asymptomatic-patients
#2
Alexandre Petnys, Pedro Puech-Leão, Antonio Eduardo Zerati, Raphael Mendes Ritti-Dias, William Carlos Nahas, Elias David Neto, Nelson De Luccia
OBJECTIVE: The increasing use of computed tomography (CT) angiography has led to more frequent diagnoses of celiac artery compression (CAC) by the median arcuate ligament (MAL). The signs of CAC by the MAL have been described as stenosis and a hook or J appearance on sagittal views. The importance of the "hook signal," however, has not been documented by studies of the normal anatomy of the celiac axis. METHODS: CT angiography images of 344 completely asymptomatic, live kidney donors (without history of chronic abdominal pain or weight loss) were reviewed...
June 15, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29909663/an-innovative-way-of-managing-coeliac-artery-stenosis-during-pancreaticoduodenectomy
#3
S Balakrishnan, S Kapoor, P Vijayanath, H Singh, A Nandhakumar, K Venkatesulu, V Shanmugam
Coeliac artery stenosis (CAS) is rarely of consequence owing to rich collateral supply from the superior mesenteric artery via the pancreatic head. Pancreaticoduodenectomy (PD) in CAS disrupts these collaterals, and places the liver, stomach and spleen at risk of ischaemia. A 56-year-old man presented with a 3-week history of obstructive jaundice. Computed tomography revealed an operable periampullary tumour with CAS due to compression by the median arcuate ligament with multiple collaterals in the pancreatic head and a prominent gastroduodenal artery (GDA)...
June 18, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29845396/a-predictive-model-for-patients-with-median-arcuate-ligament-syndrome
#4
Fred Brody, James A Randall, Richard L Amdur, Anton N Sidawy
BACKGROUND: Due to the rarity of median arcuate ligament (MAL) syndrome, patient selection for surgery remains difficult. This study provides a predictive model to optimize patient selection and predict outcomes following a MAL release. METHODS: Prospective data from patients undergoing a MAL release included demographics, radiologic studies, and SF-36 questionnaires. Successful postoperative changes in SF-36 was defined as an improvement > 10% in the total SF-36 score...
May 29, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#5
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29781769/the-laparoscopic-management-of-median-arcuate-ligament-syndrome-and-its-long-term-outcomes
#6
Henry D De'Ath, Simon Wong, Karoly Szentpali, Shaw Somers, Tom Peck, Christian H Wakefield
BACKGROUND: Case reports and small series of the surgical and radiological management of median arcuate ligament syndrome (MALS) have been described, however, long-term outcome data are lacking. The purpose of this study was to review our experience of the laparoscopic management of MALS, and describe the long-term outcomes after surgical intervention. METHODS: Data were collected between 2005 and 2016 in a single U.K. institution. All patients with MALS who underwent laparoscopic decompression of the celiac artery were included...
May 21, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29776725/collaterals-management-during-pancreatoduodenectomy-in-patients-with-celiac-axis-stenosis-a-systematic-review-of-the-literature
#7
REVIEW
Francesco Giovanardi, Quirino Lai, Manuela Garofalo, Gabriela A Arroyo Murillo, Eleonore Choppin de Janvry, Redan Hassan, Zoe Larghi Laureiro, Adriano Consolo, Fabio Melandro, Pasquale B Berloco
BACKGROUND/OBJECTIVES: Celiac axis stenosis (CAS) represents an uncommon and typically innocuous condition. However, when a pancreatic resection is required, a high risk for upper abdominal organs ischemia is observed. In presence of collaterals, such a risk is minimized if their preservation is realized. The aim of the present study is to systematically review the literature with the intent to address the routine management of collateral arteries in the case of CAS patients requiring pancreatoduodenectomy...
May 15, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29772313/treatment-of-the-median-arcuate-ligament-syndrome-in-a-patient-with-behcet-s-disease-median-arcuate-ligament-syndrome-accompanying-to-behcet-s-disease
#8
Serkan Burç Deşer, Savas Yuruker, Mustafa Kemal Demirag
Compression of the celiac artery by the median arcuate ligament (MAL) and neurofibrous tissue is called MAL syndrome or Dunbar's syndrome. Postprandial abdominal pain, weight loss are the main symptoms. Surgical treatment still remains the gold standard therapy. Here, we present the first case to our knowledge that accompanying Behcet's disease to Median Arcuate Ligament Syndrome.
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29745060/robotic-assisted-approach-to-median-arcuate-ligament-syndrome-with-left-gastric-artery-originating-directly-from-the-aorta-report-of-a-case-and-review-of-the-current-mini-invasive-treatment-modalities
#9
REVIEW
Mauro Podda, Gian Pietro Gusai, Francesco Balestra, Giulio Argenio, Fabio Pulighe, Salomone Di Saverio, Carlo De Nisco
BACKGROUND: Median Arcuate Ligament Syndrome (MALS) is a rare clinical condition. METHODS: Through the analysis of a case report and a review of the international literature, we examined whether robotic and laparoscopic MAL release are safe and feasible. RESULTS: Of 354 and 19 patients who underwent laparoscopic MAL release (LMALr) and robotic-assisted MAL release (RMALr), respectively, conversion to open surgery occurred in 6.8% of cases following LMALr, whereas no case of conversion was reported following RMALr...
May 9, 2018: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/29701344/median-arcuate-ligament-syndrome-literature-review-and-case-report
#10
Nelson Camacho, Gonçalo Alves, Frederico Bastos Gonçalves, Rodolfo Abreu, Rita Ferreira, Joana Catarino, Ricardo Correia, Rita Bento, Maria Emília Ferreira
INTRODUCTION: Median arcuate ligament syndrome (MALS) or Dunbar syndrome is a rare clinical entity characterized by celiac trunk compression by median arcuate ligament and variable gastrointestinal symptoms (postprandial epigastric pain, nausea, weight loss, anorexia and diarrhea). However, some degree of radiographic compression is observed in 10%-24% of asymptomatic patients. Besides the extrinsic vascular compression, MALS has a multifactorial etiology and it has been suggested as a neurogenic disease resulting in altered sensation and pain from the somatic nerves in the splanchnic plexus...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29695581/celiac-trunk-stenosis-treated-by-resection-and-splenic-patch-reconstruction-a-case-report-and-literature-review
#11
Nicolae Bacalbasa, Irina Balescu, Vladislav Brasoveanu
Celiac trunk stenosis is a relatively common finding; the most common causes of this obstruction are median arcuate ligament syndrome, pancreatitis, local invasion of various malignancies originating from the pancreatic body, atherosclerosis or it can be idiopathic. However, most such cases remain asymptomatic for a long period of time, especially due to the presence of a patent collateral circulation originating from the superior mesenteric artery. In certain cases, the patient might become symptomatic, diffuse post-prandial pain being reported...
May 2018: In Vivo
https://www.readbyqxmd.com/read/29678321/laparoscopic-approach-to-median-arcuate-ligament-syndrome-with-video
#12
S Landen, T Ballet, V Delugeau, C Landen
No abstract text is available yet for this article.
April 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29642943/celiac-axis-stenosis-due-to-median-arcuate-ligament-compression-in-a-patient-who-underwent-pancreatoduodenectomy-intraoperative-assessment-of-hepatic-arterial-flow-using-doppler-ultrasonography-a-case-report
#13
Masateru Yamamoto, Toshiyuki Itamoto, Akihiko Oshita, Yasuhiro Matsugu
BACKGROUND: Celiac axis stenosis due to compression by the median arcuate ligament has been reported in patients undergoing pancreaticoduodenectomy; it leads to the development of major collateral pathways that feed the hepatic artery. Dividing these important collaterals during pancreaticoduodenectomy can cause ischemic complications which may lead to a high mortality rate. To prevent these complications, it is necessary to assess intrahepatic arterial flow. CASE PRESENTATION: A 71-year-old Japanese man with anorexia was referred to us for the treatment of alcoholic chronic pancreatitis...
April 11, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29508307/usefulness-of-four-dimensional-flow-sensitive-magnetic-resonance-imaging-to-evaluate-hemodynamics-in-the-pancreaticoduodenal-artery
#14
Yasushi Shibasaki, Takanori Sakaguchi, Ryo Kitajima, Satoru Furuhashi, Ryota Kiuchi, Makoto Takeda, Takanori Hiraide, Yoshifumi Morita, Naoki Unno, Hiroya Takeuchi
Pancreaticoduodenal artery (PDA) aneurysm associated with celiac axis compression by the median arcuate ligament (MAL) is a rare disorder, but may be lethal if ruptured. Therefore, prophylactic surgical treatments need to be considered when MAL compresses the celiac axis. We herein report the usefulness of an arterial flow analysis for objectively evaluating this pathophysiology under four-dimensional flow-sensitive magnetic resonance imaging (4D-flow MRI). Celiac artery stenosis was incidentally found under contrast-enhanced CT in a 50-year-old woman with symptomatic solitary pancreatic insulinoma...
March 5, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29394834/-splenic-artery-left-common-iliac-artery-bypass-for-hepatocellular-carcinoma-with-celiac-artery-compression-syndrome-a-case-report
#15
Yoshiaki Ohmura, Yutaka Takeda, Masao Yoshitatsu, Yoshiteru Katsura, Takuya Sakamoto, Hiroki Mizoguchi, Takashi Shirakawa, Junichi Inatome, Kohei Murakami, Atsushi Naito, Yoshinori Kagawa, Toru Masuzawa, Atsushi Takeno, Chiyomi Egawa, Kohei Murata
Celiac artery compression syndrome(CACS)is a rare disorder characterized by postprandial intestinal angina caused by insufficient blood supply to the gastrointestinal organs. In this syndrome, the root of the celiac artery is compressed and narrowed by the median arcuate ligament of the diaphragm during expiration, sometimes causing difficulties in trans-arterial intervention. We report here a case that trans-hepatic arterial intervention was able to performed by splenic bypass. A 74- year-old man with multiple hepatocellular carcinoma(HCC)was performed the angiography, and diagnosed as CACS due to celiac artery root obstruction...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29383246/pancreaticoduodenectomy-with-hepatic-arterial-revascularization-for-pancreatic-head-cancer-with-stenosis-of-the-celiac-axis-due-to-compression-by-the-median-arcuate-ligament-a-case-report
#16
Takashi Miyata, Yusuke Yamamoto, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Sunao Uemura, Yoshiyasu Kato, Katsuhisa Ohgi, Atsushi Kohga, Tsuneyuki Uchida, Shusei Sano, Masahiro Nakagawa, Katsuhiko Uesaka
A 71-year-old woman presented to our hospital because pancreatic head cancer was suspected on a medical checkup. Computed tomography showed a 30 mm low-density lesion in the pancreatic head, and the stenosis of the celiac axis (CA) due to the median arcuate ligament (MAL) compression. We made a preoperative diagnosis of pancreatic head cancer and performed laparotomy. Transection of the MAL failed to restore adequate hepatic arterial flow, necessitating arterial revascularization, which was achieved by end-to-end anastomosis between the gastroduodenal artery and the middle colic artery...
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29373439/psychological-factors-and-outcomes-in-the-surgical-treatment-of-pediatric-patients-with-median-arcuate-ligament-syndrome
#17
Colleen Stiles-Shields, Christopher L Skelly, Grace Zee Mak, Christopher Speaker, Hope Boyd, Setareh O'Brien, Tina Drossos
OBJECTIVE: Median Arcuate Ligament Syndrome (MALS) is a frequently overlooked cause of chronic abdominal pain (CAP), and results in many symptoms that mimic other gastrointestinal conditions that result in CAP. A small, but growing body of literature indicates that surgery improves quality of life (QOL) in patients with MALS. The purpose of the current study was to examine the psychological characteristics of pediatric patients with MALS to determine their prevalence and impact on surgical outcomes...
January 25, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29215344/a-new-laparoscopic-manoeuvre-in-median-arcuate-ligament-syndrome
#18
Selçuk Gülmez, Ulaş Aday, Aziz Serkan Senger, Ebubekir Gündeş
No abstract text is available yet for this article.
December 1, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/29209989/pancreaticoduodenal-artery-aneurysms-due-to-median-arcuate-ligament-syndrome-what-we-need-to-know
#19
A Peyrottes, D Mariage, P Baqué, D Massalou
Median arcuate ligament (MAL) syndrome is a rare and poorly known cause of abdominal pain. MAL narrows the celiac artery (CA), resulting in true distal aneurysms, including pancreaticoduodenal artery (PDA) aneurysms. These aneurysms often have an aggressive course, as rupture can result in hemorrhagic shock. CT scan appears to be the most effective investigation for the diagnosis of PDA aneurysms and may reveal possible celiac artery compression. In this series, we describe four cases of PDA aneurysm: two ruptured aneurysms treated by an endovascular procedure and two non-ruptured aneurysms treated by surgery...
April 2018: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/29185149/laparoscopic-treatment-of-median-arcuate-ligament-syndrome-analysis-of-long-term-outcomes-and-predictive-factors
#20
Javier A Cienfuegos, Mateo G Estevez, Miguel Ruiz-Canela, Fernando Pardo, Alberto Diez-Caballero, Isabel Vivas, Jose Ignacio Bilbao, Pablo Martí-Cruchaga, Gabriel Zozaya, Víctor Valentí, José Luis Hernández-Lizoáin, Fernando Rotellar
BACKGROUND: Laparoscopic arcuate ligament release has been demonstrated a valid therapeutic option for arcuate ligament syndrome. Nevertheless, long-term follow-up and predictive factors have not been described for this treatment. METHODS: Clinical and surgical data and short- and long-term outcomes together with the impact of the degree of stenosis of the celiac trunk were analyzed in 13 consecutive patients who underwent laparoscopic arcuate ligament release between 2001 and 2013...
April 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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