Laparoscopic treatment of median arcuate ligament syndrome: A rare cause of chronic severe abdominal pain

Divarcı, Emre; Çeltik, Ülgen; Dökümcü, Zafer; Çelik, Ahmet; Ergün, Orkan

doi:10.4103/0971-9261.194624

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…It may cause various clinical symptoms such as postprandial epigastric pain, weight loss, nausea, vomiting and abdominal bruit. [ 3 ] Its diagnosis may be difficult and very often delayed. MALS remains controversial in terms of the pathophysiologic origin of the symptoms, diagnosis and optimal treatment and management.…”

Section: Introductionmentioning

confidence: 99%

Median arcuate ligament (Dunbar) syndrome

Kafadar

Oğuz

Aday

et al. 2021

Journal of Minimal Access Surgery

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Background: Median arcuate ligament syndrome (MALS) is a condition characterised by chronic abdominal symptoms associated with median arcuate ligament (MAL) compression of the coeliac artery. Aim: In this observational study, we aimed to evaluate the outcomes of laparoscopic treatment in patients with MALS. Materials and Methods: The data of ten patients with MALS who were subjected to laparoscopic sectioning of the MAL were retrospectively reviewed. The following data were evaluated: age, gender, clinical and diagnostic test findings, American Society of Anaesthesiologists score, operative findings and complications and mortality, hospital stay duration and hospital readmission. The diagnosis of MALS was established by computed tomography (CT) angiography. Results: Six (60%) of ten patients with MALS were female and four (40%) were male. The mean age was 42.4 ± 12.3. The main symptoms were epigastric pain (100%) and weight loss (60%). CT angiography showed high-grade stenosis of the anterior wall of the proximal coeliac trunk and post-stenotic dilation caused by extrinsic compression of the MAL. Surgical procedure was uneventful in all patients. Operating time was 155.5 min (120–200) and intra-operative blood loss was 150 ml (100–250). Length of stay was 3.1 day (2–9), with no mortality. The post-operative complications developed in two female patients. One of them developed ileus and the other patient developed pulmonary thromboembolism. At 6-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic decompression is an effective treatment for MALS and can provide symptomatic relief. This method may be the preferred modality of treatment in view of its lack of morbidity and good results.

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Section: Introductionmentioning

confidence: 99%