In median arcuate ligament syndrome (MALS), the median arcuate ligament compresses the celiac trunk and surrounding nerves leading to chronic functional abdominal pain and vague gastrointestinal symptoms. MALS can be effectively treated by dividing the arcuate ligament through open surgery or laparoscopy. This is a rare vascular condition and mostly encountered in adult patients. We hereby report a case of a pediatric patient diagnosed with MALS and treated successfully by laparoscopic approach. An 11-year-old girl presented with severe abdominal cramps for 3 months, accompanied by nonbilious vomiting. Computed tomography (CT) angiography demonstrated clear images of celiac trunk compression suggesting MALS. Laparoscopic surgery to cut the ligament and decompress the celiac artery was performed. The patient was discharged on day 7 postoperative with no recurrence of symptoms after 12 months of follow-up. This report suggested the diagnostic value of CT scan, and the safety and the feasibility of laparoscopic surgical techniques to treat MALS in children.
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http://dx.doi.org/10.1016/j.radcr.2024.02.038 | DOI Listing |
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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