Median arcuate ligament (MAL) syndrome, also known as the celiac axis compression syndrome (CACS) is rare, and a topic of ongoing academic controversy. CACS is a diagnosis of exclusion, characterized by the clinical triad of postprandial abdominal pain, weight loss, and vomiting. The classic management of CACS involves the surgical division of the MAL fibers. We report successful treatment of a 23-year-old woman with CACS utilizing the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, California) via robotic-assisted minimally invasive surgical division of the MAL. To our knowledge this is the first report of this modality used in the treatment of the celiac axis compression syndrome.
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Neurospine
December 2024
Department of Neurosurgery, Chosun University Hospital, Gwangju, Korea.
This case report and video demonstrate the technique of full-endoscopic J-shaped transforaminal L5 exiting nerve decompression in Bertolotti syndrome. Bertolotti syndrome, characterized by a congenital lumbosacral transitional vertebra, often results in mechanical lower back pain and nerve root compression. A 69-year-old male presented with progressive radiating pain in the right leg and tingling in the L5 dermatome.
View Article and Find Full Text PDFNeurospine
December 2024
Department of Neurosurgery, Spine Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
The main aim of this video article is to demonstrate the combined use of O-arm navigation and unilateral biportal endoscopy (UBE) to manage far-out syndrome (FOS). In FOS there is entrapment and compression of the fifth lumbar nerve beyond the foramen and between L5 transverse process and the sacral ala at the lumbosacral junction. Conventional microscopic decompression using a paraspinal approach had been the gold standard for its management.
View Article and Find Full Text PDFRadiol Case Rep
March 2025
Unit of Neurosurgery, Sant'Elia Hospital, via Luigi Russo n° 6, Caltanissetta, Italy.
Background: Quadrilateral space syndrome is a painful disorder of the shoulder caused by static or dynamic entrapment of the axillary nerve and the posterior humeral circumflex artery. It was first described in 1983; however, it is an uncommon syndrome that initially presents with nonspecific shoulder pain or selective deltoid atrophy, and diagnosis is often delayed owing to its rarity. Young athletes of overhead sports are more commonly affected by this syndrome.
View Article and Find Full Text PDFAm J Forensic Med Pathol
December 2024
Forensic Pathology Unit, Royal Darwin Hospital, Darwin, Northern Territory and College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Constipation is found in individuals with intellectual disabilities, autism, and cerebral palsy. Although generally a benign condition, it may lead to life-threatening intestinal obstruction, with or without volvulus, or to stercoral ulceration with enteritis and/or perforation. Two unusual cases of lethal chronic constipation are reported to demonstrate other very rare fatal mechanisms that may occur.
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