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Median arcuate ligament

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https://www.readbyqxmd.com/read/28904981/median-arcuate-ligament-syndrome-it-is-not-always-gastritis
#1
Aneesh Kuruvilla, Ghulam Murtaza, Ayesha Cheema, Hafiz Muhammad Sharjeel Arshad
Median arcuate ligament syndrome is a rare disorder that is clinically characterized by the triad of postprandial abdominal pain, weight loss, and often an abdominal bruit due to compression of the celiac artery by the median arcuate ligament. Given the nonspecific symptoms, this is a rare and difficult diagnosis to obtain. We present a patient with nonspecific abdominal pain in whom etiology was ultimately determined to be median arcuate ligament syndrome.
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28892965/dunbar-syndrome-a-rare-cause-of-foregut-ischemia
#2
Tagore Sunkara, Megan E Caughey, Kevin Cai Zhen, Brian Chiong, Vinaya Gaduputi
Median Arcuate Ligament Syndrome (MALS) is a condition that can result from an anatomical aberration. If the median arcuate ligament is located too inferiorly in relation to the celiac axis, it can impede circulation and lead to vascular compromise. Here, we present the case of a 63-year-old woman, who came to the hospital complaining of continuous epigastric pain and who was ultimately found to have MALS. Her epigastric pain could be the result of the ischemia caused by MALS that made it difficult for the duodenal ulcer to heal properly...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28859519/intraoperative-measurement-of-pressure-gradient-in-median-arcuate-ligament-syndrome-as-a-rationale-for-radical-surgical-approach
#3
Tomas Grus, Lukas Lambert, Tomas Vidim, Gabriela Grusova, Tomas Klika
BACKGROUND: Median arcuate ligament syndrome (MALS) describes clinical symptoms in patients with stenosis of the celiac artery due to external compression by the ligament. There is an ongoing debate, whether sole release of the median arcuate ligament warrants long-term relief of the symptoms. MATERIALS AND METHODS: Eight patients diagnosed with MALS underwent open surgical treatment beginning with the release of the ligament. Systemic pressure and pressure in the left gastric artery were measured before and after division of the median arcuate ligament and release of the celiac artery...
August 31, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28851450/open-vascular-treatment-of-median-arcuate-ligament-syndrome
#4
Mansur Duran, Florian Simon, Neslihan Ertas, Hubert Schelzig, Nikolaos Floros
BACKGROUND: Median arcuate ligament syndrome is a rare condition with abdominal symptoms. Accepted treatment options are open release of median arcuate ligament, laparoscopic release of edian arcuate ligament, robot-assisted release of median arcuate ligament and open vascular treatment. Here we aimed to evaluate the central priority of open vascular therapy in the treatment of median arcuate ligament syndrome. METHODS: We conducted a monocentric retrospective study between January 1996 and June 2016...
August 29, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28744083/imaging-features-of-vascular-compression-in-abdomen-fantasy-phenomenon-or-true-syndrome
#5
Sitthipong Srisajjakul, Patcharin Prapaisilp, Sirikan Bangchokdee
Vascular structures in the abdomen can compress or be compressed by adjacent structures. Classic imaging findings of vascular compressions, including median arcuate ligament syndrome, superior mesenteric artery syndrome, nutcracker syndrome, portal biliopathy, May-Thurner syndrome, and ureteropelvic junction obstruction will be discussed here. It is important to correlate imaging findings and clinical data to identify asymptomatic vascular compression which requires no treatment, intermittent vascular compression with nonspecific or vague clinical manifestation, and the subset of patients with true syndromes who will benefit from treatment...
April 2017: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/28738298/laparoscopic-treatment-of-dunbar-syndrome-a-case-report
#6
Orlando Jorge M Torres, Ozimo Pereira Gama-Filho, Camila Cristina Salazar Torres, Ricardo Mary Medeiros, Caio Márcio Barros Oliveira
BACKGROUND: Dunbar syndrome is a rare disorder due to external compression of the celiac trunk by the median arcuate ligament. The symptoms include abdominal pain, nausea and vomiting. Laparoscopic treatment was suggested as a safe procedure. The aim of this study is to present a case of Dunbar syndrome underwent laparoscopic treatment. CASEPRESENTATION: A 17-year-old female patient presented at emergency room with upper abdominal pain and dyspepsia, related to food intake...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28535930/ruptured-pancreaticoduodenal-artery-aneurysm-due-to-a-median-arcuate-ligament-treated-solely-by-revascularization-of-the-celiac-trunk
#7
Lucie Salomon du Mont, Fanny Lorandon, Julien Behr, Betty Leclerc, Emilie Ducroux, Simon Rinckenbach
Pancreaticoduodenal artery aneurysms (PDAAs) are rare, but rupture can occur at any time regardless of the size. We describe here the case of 53-year-old woman who presented with a ruptured PDAA associated with compression of the celiac trunk by the median arcuate ligament. We first performed revascularization of the celiac trunk without intervening on the PDAA because of surgically hostile conditions. We observed complete regression of the PDAA, probably due to the dramatic decrease in inflow to the PDAA, thanks to the revascularization procedure...
August 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28493483/preoperative-imaging-and-prediction-of-oesophageal-conduit-necrosis-after-oesophagectomy-for-cancer
#8
P Lainas, D Fuks, S Gaujoux, Z Machroub, A Fregeville, T Perniceni, F Mal, B Dousset, B Gayet
BACKGROUND: Oesophageal conduit necrosis following oesophagectomy is a rare but life-threatening complication. The present study aimed to assess the impact of coeliac axis stenosis on outcomes after oesophagectomy for cancer. METHODS: The study included consecutive patients who had an Ivor Lewis procedure with curative intent for middle- and lower-third oesophageal cancer at two tertiary referral centres. All patients underwent preoperative multidetector CT with arterial phase to detect coeliac axis stenosis...
September 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28473083/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-mesenteric-ischemia
#9
Nicholas Fidelman, Ali F AbuRahma, Brooks D Cash, Baljendra S Kapoor, M-Grace Knuttinen, Jeet Minocha, Paul J Rochon, Colette M Shaw, Charles E Ray, Jonathan M Lorenz
Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Recommended therapy for chronic mesenteric ischemia includes angioplasty with or without stent placement and, if an endovascular approach is not possible, surgical bypass or endarterectomy...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28462569/exercise-induced-median-arcuate-ligament-syndrome-in-athletes-case-series
#10
Yasmin Grant, Sarah Onida, Brahman Dharmarajah, Emma B Davies, Alun H Davies
The median arcuate ligament (MAL) is a fibrous arch connecting the right and left diaphragmatic crura; this usually lies superior to the origin of the coeliac axis. Occasionally, the ligament crosses anterior to the aorta, at the level of the coeliac trunk; leading to mechanical compression of the coeliac artery, resulting in the clinical condition of MAL syndrome (MALS). Symptomatic patients characteristically present with post-prandial pain associated with unintentional weight loss, nausea, vomiting and diarrhoea...
April 28, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28395788/diagnosis-and-treatment-of-chronic-mesenteric-ischemia-an-update
#11
REVIEW
Jeroen J Kolkman, Robert H Geelkerken
Although the prevalence of mesenteric artery stenoses (MAS) is high, symptomatic chronic mesenteric ischemia (CMI) is rare. The collateral network in the mesenteric circulation, a remnant of the extensive embryonal vascular network, serves to prevent most cases of ischemia. This explains the high incidence of MAS and relative rarity of cases of CMI. The number of affected vessels is the major determinant in CMI development. Most subjects with single vessel mesenteric stenosis do not develop ischemic complaints...
February 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28381781/a-case-report-of-duodenal-obstruction-due-to-retroperitoneal-bleeding-after-the-rupture-of-a-lower-pancreaticoduodenal-artery-aneurysm
#12
REVIEW
Nobuhiro Takeuchi, Kazumasa Emori, Yusuke Nomura
We report a case of a patient with duodenal obstruction due to retroperitoneal bleeding after the rupture of a lower pancreaticoduodenal artery aneurysm. An 80-year-old female was admitted to our hospital because of nausea and vomiting. During hospitalization, she developed hemorrhagic shock. Enhanced computed tomography revealed retroperitoneal bleeding. Abdominal angiography revealed an 8-mm aneurysm of the lower pancreaticoduodenal artery, stenosis at the trunk of the celiac artery, and increased blood flow through the pancreaticoduodenal arcades from the superior mesenteric artery...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28302657/vascular-challenges-from-pancreatoduodenectomy-in-the-setting-of-coeliac-artery-stenosis
#13
Joal D Beane, Roderich E Schwarz
Coeliac artery stenosis due to median arcuate ligament compression or atherosclerotic disease is a frequently unrecognised challenge to recovery after pancreatoduodenectomy. The described case illustrates management with intraoperative superior mesenteric artery to hepatic artery bypass graft that led to haemorrhagic challenges postoperatively but ultimately a good recovery. Aspects of preoperative diagnosis, preoperative intervention and intraoperative management options are reviewed. Surgeons need to possess these tools to prevent complications from coeliac artery stenosis when pancreatoduodenectomy is required...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28286755/aneurysms-of-peripancreatic-arterial-arcades-coexisting-with-celiac-trunk-stenosis-or-occlusion-single-institution-experience
#14
Robert Antoniak, Laretta Grabowska-Derlatka, Ireneusz Nawrot, Andrzej Cieszanowski, Olgierd Rowiński
Introduction. True aneurysms of peripancreatic arterial arcades (PAAAs) are rare. Most of them coexist with celiac axis stenosis/occlusion due to median arcuate ligament (MAL) compression or atherosclerosis. The aim of this study was to evaluate the cause of celiac axis lesion and characterize the anatomy of the aneurysms. These findings may have important management implications. Material and Methods. A retrospective analysis of 15 patients with true PAAAs was performed. The diagnosis was established by contrast-enhanced CT, using a 64-MDCT scanner...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28223737/pancreaticoduodenectomy-secondary-stenting-of-the-celiac-trunk-after-inefficient-median-arcuate-ligament-release-and-reoperation-as-an-alternative-to-simultaneous-hepatic-artery-reconstruction
#15
Théophile Guilbaud, Jacques Ewald, Olivier Turrini, Jean Robert Delpero
In patients undergoing pancreaticoduodenectomy (PD), unrecognized hemodynamically significant celiac axis (CA) stenosis impairs hepatic arterial flow by suppressing the collateral pathways supplying arterial flow from the superior mesenteric artery and leads to serious hepatobiliary complications due to liver and biliary ischemia, with a high rate of mortality. CA stenosis is usually due to an extrinsic compression by a previously asymptomatic median arcuate ligament (MAL). MAL is diagnosed by computerized tomography in about 10% of the candidates for PD, but only half are found to be hemodynamically significant during the gastroduodenal artery clamping test with Doppler assessment, which is mandatory before any resection...
February 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28124567/phase-contrast-mri-evaluation-of-haemodynamic-changes-induces-by-a-coeliac-axis-stenosis-in-the-gastroduodenal-artery
#16
Audrey Haquin, Monica Sigovan, Salim Si-Mohamed, Jean-Yves Mabrut, Anne-Frédérique Manichon, Melisa Bakir, Agnès Rode, Loïc Boussel
OBJECTIVE: To evaluate the correlation between the gastroduodenal artery (GDA) haemodynamic changes and the degree of coeliac axis (CA) stenosis using phase-contrast MRI. METHODS: The study was institutional review board approved, and written informed consent was obtained from patients included prospectively. A two-dimensional phase-contrast MRI was performed in 23 patients scheduled for a potential complex supramesocolic surgery, in a plane perpendicular to the GDA, during inspiration and expiration...
April 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28050657/median-arcuate-ligament-syndrome-a-single-center-experience-with-23-patients
#17
Layla A Nasr, Walid G Faraj, Aghiad Al-Kutoubi, Mohamad Hamady, Mohamad Khalifeh, Ali Hallal, Hamzeh M Halawani, Joelle Wazen, Ali A Haydar
BACKGROUND: Median arcuate ligament syndrome (MALS) is a rare entity that occurs when the median arcuate ligament of the diaphragm is low-lying, causing a compression to the underlying celiac trunk. We reviewed the vascular changes associated with MALS in an effort to emphasize the seriousness of this disease and the complications that may result. METHODS: This is a retrospective descriptive analysis of 23 consecutive patients diagnosed with MALS between January 1, 2012 and December 31, 2015 at a tertiary medical center...
May 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28017582/outcomes-of-conservative-management-of-spontaneous-celiac-artery-dissection
#18
Akihiro Hosaka, Masaru Nemoto, Tetsuro Miyata
OBJECTIVE: Spontaneous celiac artery (CA) dissection without associated aortic dissection is a rare condition. Although this condition has been diagnosed more frequently with the advent of improved diagnostic imaging modalities, its pathogenesis and treatment strategy remain to be established. The present study examined the clinical features and outcomes of conservative management of this disease. METHODS: The study included 12 patients (10 men and two women) in whom spontaneous CA dissection was diagnosed between 2007 and 2015...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27980769/median-arcuate-ligament-syndrome-case-presentation-and-video-illustrated-laparoscopic-management
#19
Antoine El Asmar, Ziad El Rassi
Laparoscopic release of the median arcuate ligament, to relieve symptomatic compression of the celiac trunk, is the ideal approach when performed in a specialized center, by a surgeon with the adequate experience in advanced laparoscopic surgery.
December 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27896401/sleeve-gastrectomy-combined-with-the-simplified-hill-repair-in-the-treatment-of-morbid-obesity-and-gastro-esophageal-reflux-disease-preliminary-results-in-14-patients
#20
Daniel Gero, Lara Ribeiro-Parenti, Konstantinos Arapis, Jean-Pierre Marmuse
BACKGROUND: Our aim is to report our initial experience with a novel technique which addresses morbid obesity and gastro-esophageal reflux disease (GERD) simultaneously by combination of laparoscopic sleeve gastrectomy (LSG) and simplified laparoscopic Hill repair (sLHR). METHODS: Retrospective analysis of LSG+sLHR patients >5 months postoperatively includes demographics, GERD status, proton-pump inhibitor (PPI) use, body mass index (BMI), excess BMI loss (EBMIL), complications and GERD-Health Related Quality of Life (GERD-HRQL) questionnaire...
April 2017: World Journal of Surgery
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