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median arcuate syndrome

Ilhan Karabicak, Sohei Satoi, Hiroaki Yanagimoto, Tomohisa Yamamoto, Satoshi Hirooka, So Yamaki, Hisashi Kosaka, Masaya Kotsuka, Kentoro Inoue, Yoichi Matsui, Masanori Kon
Median arcuate ligament syndrome (MALS) has been reported in 2-7.6 % of patients undergoing pancreaticoduodenectomy (PD). Most of the reported cases of MALS have been diagnosed perioperatively and treated radiologically or surgically before or during PD. MALS can have an acute postoperative onset after PD even if all preoperative and intraoperative evaluations are normal particularly in young patients.In this report, we present a second case of severe hepatic cytolysis secondary to MALS that developed acutely and the first patient who required acute division of the median arcuate ligament after PD...
December 2016: Surgical Case Reports
Mitsuru Sato, Shunsuke Kawamoto, Yoshikatsu Saiki
Aneurysm in the pancreatic arcade artery is an uncommon event, and is usually associated with the condition of median arcuate ligament syndrome. The stenosis at the base of the celiac axis has been presumed to be attributable to a relative increase in flow and pressure within the pancreatic arcade, resulting in subsequent development of the aneurysm. We, herein, present a rare case with rapid development of a pancreatic arcade artery aneurysm immediately after the replacement of a thoracoabdominal aortic aneurysm...
2016: Annals of Vascular Diseases
Tom Hughes, Nikolaos A Chatzizacharias, James Richards, Simon Harper
INTRODUCTION: Inferior pancreatico-duodenal artery (IPDA) aneurysms are very rare and commonly associated with coeliac axis stenosis or occlusion due to atherosclerosis, thrombosis or median arcuate ligament syndrome. We present a case of a surgical repair of an IPDA aneurysm with the use of a supra-coeliac aorto-hepatic bypass with a polytetrafluoroethylene (PTFE) graft, following a failed initial attempt at an endovascular repair. PRESENTATION: A 75 year old female, who was under investigation for night sweats, was referred to our team with an incidental finding of a 19mm fusiform IPDA aneurysm...
September 26, 2016: International Journal of Surgery Case Reports
Kevin Cheng, Adam Doyle, Dean C Spilias, Kenneth K Lau
The median arcuate ligament syndrome is a rare disorder characterised by postprandial intestinal angina caused by compression of the coeliac artery by the median arcuate ligament. To date, the diagnosis and treatment of median arcuate ligament syndrome has remained controversial. To our knowledge, this is the first reported case of coeliac artery compression demonstrated on the four-dimensional wide-area detector CT angiogram.
September 7, 2016: Journal of Medical Imaging and Radiation Oncology
Kevin O'Brien, Hector Ferral
The median arcuate ligament (MAL) can rarely compress both the celiac axis and superior mesenteric artery. We present a case of a 70-year male who presented with isolated episodes of upper abdominal pain and diarrhea associated with sweats and nausea. Angiography images demonstrated complete occlusion of the celiac axis and compression of the superior mesenteric artery during the expiration phases. The celiac axis was reconstituted distal to its origin by a patent Arc of Buhler. Other reported cases of multivessel MALs have produced severe symptoms in young adults requiring surgical and/or endovascular intervention...
September 2016: Radiology case reports
Agata Arazińska, Michał Polguj, Andrzej Wojciechowski, Łukasz Trębiński, Ludomir Stefańczyk
PURPOSE: Median arcuate ligament syndrome (MALS) is a pathologic entity that can affect the celiac axis. Due to the extensive collateral network of mesenteric circulation, stenosis of one mesenteric artery does not lead to significant symptoms. The purpose of this study was to describe multidetector computed tomography (MDCT) angiography findings of celiac artery entrapment by the median arcuate ligament and determine those patients with high risks of ischemic complications. MATERIALS AND METHODS: From January 2012 to March 2016, 103 patients with celiac artery (CA) compression by median arcuate ligament were detected...
August 25, 2016: Clinical Anatomy
Grace Zee Mak, Amanda R Lucchetti, Tina Drossos, Ellen E Fitzsimmons-Craft, Erin C Accurso, Colleen Stiles-Shields, Erika A Newman, Christopher L Skelly
Chronic abdominal pain (CAP) occurs in children and adolescents with a reported prevalence of 4% to 41% with significant direct and indirect costs to the child, family, and society. Median arcuate ligament syndrome (MALS) is a vascular compression syndrome of the celiac artery that may cause symptoms of epigastric pain and weight loss and is a frequently overlooked cause of CAP in the pediatric population. We have observed that the psychosocial presentation of patients with MALS is notable for various psychiatric comorbidities...
July 1, 2016: Pediatric Annals
Naoki Notani, Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Hiroshi Tsumura
PURPOSE: To describe the first case of a patient who developed acute celiac artery compression syndrome (ACACS) after extensive correction of sagittal balance on an adult spinal deformity. METHODS: A 77-year-old woman presented with low back pain and spinal kyphosis deformity. We performed a two-stage correction with extreme lateral interbody fusion (XLIF), and her lumbar lordosis improved from -47° to 53°. However, after surgery, she experienced frequent vomiting and diarrhea...
June 23, 2016: European Spine Journal
Parthasarathy Ramakrishnan, Biswajit Deuri, M S S Keerthi, Subrahmaneswara Babu Naidu, Rajapandian Subbaiah, Praveen Raj, Senthilnathan Palanisamy, Palanivelu Chinnusamy
Median arcuate ligament (MAL) syndrome is an uncommon condition caused by the external compression of the celiac trunk by the median arcuate ligament. In the current era of technological advancement, this syndrome may be corrected through the laparoscopic approach. We report two patients who were diagnosed as MAL syndrome and underwent laparoscopic division of MAL fibers at our institute. Both the patients improved symptomatically following the procedure and were discharged on the fourth post-operative day...
April 2016: Indian Journal of Surgery
Jeffrey N Harr, Ivy N Haskins, Fred Brody
BACKGROUND: Exercise-related transient abdominal pain (ETAP) is a common entity in young athletes. Most occurrences are due to a "cramp" or "stitch," but an uncommon, and often overlooked, etiology of ETAP is median arcuate ligament syndrome (MALS). The initial presentation of MALS typically includes postprandial nausea, bloating, abdominal pain, and diarrhea, but in athletes, the initial presentation may be ETAP. METHODS: We present a case series of three athletes who presented with exercise-related transient abdominal pain and were ultimately diagnosed and treated for MALS...
May 13, 2016: Surgical Endoscopy
Akihiko Sakatani, Yoshinori Doi, Toshiaki Kitayama, Takaaki Matsuda, Yasutaka Sasai, Naohiro Nishida, Megumi Sakamoto, Naoto Uenoyama, Kazuo Kinoshita
Pancreaticoduodenal artery aneurysms are a rare type of visceral artery aneurysm, whose rupture is associated with high mortality. These aneurysms are of particular interest because local haemodynamic change caused by coeliac artery obstruction plays an important role in their development. However, the pathophysiological mechanism of coeliac artery obstruction is not completely understood. Pressure from the median arcuate ligament is most frequently reported cause. Although it is well-known that stenosis or occlusion of the visceral vessels may be caused by aortic syndrome, reports of pancreaticoduodenal artery aneurysm associated with coeliac artery occlusion due to aortic syndrome are extremely rare...
April 28, 2016: World Journal of Gastroenterology: WJG
F H Ng, Ophelia K H Wai, Agnes W Y Wong, S M Yu
No abstract text is available yet for this article.
April 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Enrique Criado
Surgical revascularization for chronic or acute mesenteric ischemia is often technically challenging. In many instances, because of the presence of hostile abdominal conditions or the lack of adequate intra-abdominal arterial inflow sources, alternative surgical approaches that avoid the abdomen and use a more proximal source of arterial inflow are necessary. In these situations, a bypass from the descending or ascending thoracic aorta to the mesenteric vessels may be the only viable option. However, the standard thoracoabdominal approach for mesenteric revascularization carries an extensive surgical insult, and in some situations, this approach does not obviate hostile abdominal pathology...
May 2016: Annals of Vascular Surgery
Erinn N Kim, Kathleen Lamb, Daniel Relles, Neil Moudgill, Paul J DiMuzio, Joshua A Eisenberg
IMPORTANCE: Median arcuate ligament (MAL) syndrome is a rare disease resulting from compression of the celiac axis by fibrous attachments of the diaphragmatic crura, the median arcuate ligament. Diagnostic workup and therapeutic intervention can be challenging. OBJECTIVE: To review the literature to define an algorithm for accurate diagnosis and successful treatment for patients with MAL syndrome. EVIDENCE REVIEW: A search of PubMed (1995-September 28, 2015) was conducted, using the key terms median arcuate ligament syndrome and celiac artery compression syndrome...
May 1, 2016: JAMA Surgery
Yashant Aswani, Hemangini Thakkar, Karan Manoj Anandpara
No abstract text is available yet for this article.
2015: BMJ Case Reports
Deniz Akan, Alper Ozel, Ozge Orhan, Emre Bozdag, Muzaffer Basak
Median arcuate ligament syndrome (MALS), also known as celiac artery compression syndrome is a rare condition characterized by chronic mesenteric ischemia, secondary to the compression of the celiac artery by the median arcuate ligament. Occasionally, in addition to the celiac artery, the superior mesenteric artery may be partially compressed by the median arcuate ligament. We report a case with complaints of chronic abdominal pain from compression of both the celiac artery and the superior mesenteric artery due to MALS, which was primarily detected by Doppler ultrasound...
December 2015: Medical Ultrasonography
Ivy N Haskins, Jeffrey N Harr, Fred Brody
Exercise-related transient abdominal pain is a common entity in young athletes. An uncommon aetiology of this type of pain is median arcuate ligament syndrome. This article details an 18-year-old field hockey player who presented with a 1-year history of exercise-related transient abdominal pain. Despite a trial of preventative strategies, the patient's pain persisted, prompting surgical intervention. Following a laparoscopic median arcuate ligament release, the patient's symptoms resolved. Therefore, when exercise-related transient abdominal pain persists despite precautionary measures, median arcuate ligament syndrome should be considered...
2016: Journal of Sports Sciences
Michael Czihal, Ramin Banafsche, Ulrich Hoffmann, Thomas Koeppel
Dealing with vascular compression syndromes is one of the most challenging tasks in Vascular Medicine practice. This heterogeneous group of disorders is characterised by external compression of primarily healthy arteries and/or veins as well as accompanying nerval structures, carrying the risk of subsequent structural vessel wall and nerve damage. Vascular compression syndromes may severely impair health-related quality of life in affected individuals who are typically young and otherwise healthy. The diagnostic approach has not been standardised for any of the vascular compression syndromes...
November 2015: VASA. Zeitschrift Für Gefässkrankheiten
Qasam M Ghulam, Kim K Bredahl, Thomas Axelsen, Lisbeth E Hvolris, Viggo B Kristiansen, Svend Schulze, Lisbeth G Jørgensen, Torben V Schroeder, Jonas P Eiberg
The median arcuate ligament syndrome is a rare entity and poorly described in Danish literature. The syndrome is a diagnosis of exclusion and is characterized by chronic abdominal pain, postprandial pain and weight loss. It is believed that the median arcuate ligament, being a fibrous structure of diaphragm, compresses the coeliac trunk thus causing stenosis and malperfusion of the gastrointestinal organs. Until recently, there has been some reluctance to consider intervention with revascularization or ligament release...
September 21, 2015: Ugeskrift for Laeger
John M Weber, Mena Boules, Kathryn Fong, Benjamin Abraham, James Bena, Kevin El-Hayek, Matthew Kroh, Woosup Michael Park
BACKGROUND: Median arcuate ligament syndrome (MALS) is a rare disorder characterized by postprandial abdominal pain, weight loss, and celiac stenosis. Diagnosis can be challenging, leading to a delay in treatment. We report on our continued experience using a laparoscopic approach for this uncommon diagnosis. METHODS: This is an Institutional Review Board-approved, prospectively collected retrospective analysis of patients treated with laparoscopic MAL release at our institution...
January 2016: Annals of Vascular Surgery
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