Background: Arcuate ligament vascular compression syndrome has not been described previously in the pediatric or pediatric surgical literature. However, it is mentioned in the literature of vascular and general surgery and in journals of radiology and orthopedics. In this review, the intraoperative pathological anatomy and the principles of treatment for 8 children will be presented.
Methods: The chart records and the anatomical sketches that were documented by the surgeon immediately after each procedure were analyzed retrospectively. In addition, preoperative courses and long-term follow-up (range, 3-18 years) were evaluated by a defined program.
Results: The diagnosis of celiac artery compression by an arcuate ligament was suspected in children presenting with a history of several years of recurrent acute abdominal pain associated with a typical arterial bruit in the midline of the epigastric region.
Conclusions: Other diseases with recurrent abdominal pain and an arterial bruit must be excluded before making the decision for an operative intervention. Duplex ultrasound and angiography are possibly helpful tools to establish the respective diagnosis, but in the patients of the present series, these techniques neither confirmed compression of the celiac axis nor demonstrated decreased perfusion of the superior mesenteric artery. However, as the clinical symptoms clearly announce the disease, these diagnostic measures are not mandatory.
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http://dx.doi.org/10.1016/j.jpedsurg.2005.06.040 | DOI Listing |
J Med Ultrasound
April 2024
Department of Anesthesiology, The School of Clinical Medicine, Fujian Madical University, The First Hospital of Putian City, Fujian, China.
Background: To test the novel ultrasound (US)-guided bilateral anterior quadratus lumborum block (QLBA) at the lateral supra-arcuate ligament (supra-LAL) technique combined with postoperative intravenous analgesia was a viable alternative approach of conventional thoracic epidural analgesia (TEA) for laparoscopic radical gastrectomy (LRG).
Methods: Three hundred and four patients scheduled for LRG were randomized 1:1 into QLBA group: receiving a novel pathway of US-guided bilateral QLBA at the supra-LAL before general anesthesia (GA) and patient-controlled intravenous analgesia (PCIA) after surgery, and TEA group: receiving TEA before GA and patient-controlled epidural analgesia following surgery. The difference in procedure time between the treatment groups was set as the primary endpoint.
Aust J Gen Pract
December 2024
MBBS, Senior Registrar, Department of Vascular Surgery, Princess Alexandra Hospital, Woolloongabba, Qld.
Background: Median arcuate ligament syndrome (MALS) occurs due to extrinsic compression of the coeliac plexus, leading to postprandial and exercise-induced epigastric pain, nausea, vomiting, food fear and weight loss. Diagnosis can be challenging as up to 25% of the population have radiological compression. However, only 1% of the population have corresponding symptoms.
View Article and Find Full Text PDFJ Surg Case Rep
December 2024
Department of Radiology, Rafedia Hospital, Rafidia Main Street, Nablus, Palestine.
Dieulafoy lesions are a rare cause of gastrointestinal bleeding, characterized by an enlarged submucosal blood vessel that bleeds without visible abnormalities. The diagnosis is typically made via endoscopy, and treatment usually involves endoscopic therapy. This case involves a 46-year-old female who presented with upper gastrointestinal bleeding due to a Dieulafoy's lesion, treated with band ligation and later embolization after the lesion was found to originate from the left phrenic artery.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
February 2025
Division of Vascular Surgery, Department of Surgery, The Mount Sinai Medical Center, New York, NY.
Inferior pancreaticoduodenal artery aneurysm (IPDA) with the stenosis of the celiac axis is rare and may cause rupture. A unique etiology of IPDAs with celiac stenosis is median arcuate ligament syndrome. These aneurysms develop as a result of the dilation of the arteries from the retrograde blood flow into the pancreaticoduodenal arches because of celiac artery compression by the median arcuate ligament.
View Article and Find Full Text PDFUpdates Surg
December 2024
Department of Surgery, Division of Surgical Oncology, University of Pittsburgh, 200 Lothrop St, 3rd Fl, Suite D380, Digestive Disorder Clinic, Pittsburgh, PA, 15213-2536, USA.
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