Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain in adult and infant. This syndrome typically occurs in thin women, who may present with epigastric pain and weight loss. The aim of this study was to report our first case of a 10-year-old girl patient treated with laparoscopic liberation of the celiac trunk artery in Median Arcuate Ligament Syndrome (MALS) in our Pediatric center. Case Report: A thin female of 10-year-old with chronic postprandial abdominal pain accompanying vegetative symptoms: nausea, vomiting, dizziness, tachycardia, weight loss and sweating. Her physical examination revealed epigastric pain to palpation and low weight. An abdominal ultrasound showed celiac artery flow of 116 cm/s and Resistance Index (RI) =0.76. In the same sense, an angiotomography was performed and showed a high-grade stenosis involving the origin of the celiac trunk and hemodynamic study was performed too. Results: The duration of the procedure was 154 minutes. The postoperative hospital recovery period was 3 days. No intraoperative or postoperative complications occurred: bleeding events, blood transfusions and stenosis of the celiac trunk. The patient accepted well the cosmetic aspect without pain. Conclusion: The outcome of the pediatric patient was satisfactory, and the laparoscopic procedure liberation of the celiac trunk was sufficient in this case. Laparoscopic liberation of celiac trunk is reliable and a less invasive procedure with good results and cosmetic aspect in pediatric patient.

Introduction:Neuroblastoma is relatively rare. The aim of this study was to evaluate the outcome with special focus on postoperative follow-up of a newborn with left prenatal cystic mass that evolved into lesion of mixed echogenicity with cystic and solid components.Case Presentation: Ultrasound examination at 39 weeks of gestation revealed oligohydramnios and a cystic mass with the inability to evaluate the left fetal kidneys. Subsequently, the mother underwent an abdominal cesarean delivery of a healthy boy of 3.4kg. Physical examination was normal other than a large mass was palpable on upper pole of the left kidney. Postnatal ultrasound examination showed a predominantly solid suprarenal mass deforming the upper pole of the left kidney.The scan demonstrated alteration of kidney structure and displacement of the spleen and intestinal structures. The patient was admitted to an abdominal exploration with the most probable diagnosis at this stage of a cystic neuroblastoma or an adrenal hematoma as main differential diagnosis. Results:The duration of the procedure was 240 minutes. The postoperative hospital recovery period was 20 days. No intraoperative or postoperative complications occurred. He had ultrasound control every 2 months with good report, the last control of marker tumor was normal and at 14 months after the procedure he continues with a favorable outcome. Conclusions:The outcome of this patient was satisfactory the early detection although prenatal ultrasound and the early surgical treatment may diminish the risk of liver metastasis and chemotherapy treatment.