Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience.

Autor:	Giakoustidis A; Department of Surgery, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki 56429, Greece.; Fifth Department of Surgery, Interbalkan European Medical Centre, Thessaloniki 55535, Greece., Moschonas S; Department of Surgery, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki 56429, Greece., Christodoulidis G; Department of General Surgery, University Hospital of Larissa, Larissa 41110, Greece. gregsurg@yahoo.gr., Chourmouzi D; Fifth Department of Surgery, Interbalkan European Medical Centre, Thessaloniki 55535, Greece., Diamantidou A; Fifth Department of Surgery, Interbalkan European Medical Centre, Thessaloniki 55535, Greece., Masoura S; Fifth Department of Surgery, Interbalkan European Medical Centre, Thessaloniki 55535, Greece., Louri E; Fifth Department of Surgery, Interbalkan European Medical Centre, Thessaloniki 55535, Greece., Papadopoulos VN; Department of Surgery, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki 56429, Greece., Giakoustidis D; Department of Surgery, General Hospital Papageorgiou, Aristotle University of Thessaloniki, Thessaloniki 56429, Greece.; Fifth Department of Surgery, Interbalkan European Medical Centre, Thessaloniki 55535, Greece.
Jazyk:	angličtina
Zdroj:	World journal of gastrointestinal surgery [World J Gastrointest Surg] 2023 Jun 27; Vol. 15 (6), pp. 1048-1055.
DOI:	10.4240/wjgs.v15.i6.1048
Abstrakt:	The median arcuate ligament syndrome (MALS) is recognized as a rare clinical entity, characterized by chronic post-prandial abdominal pain, nausea, vomiting, and unintentional weight loss. Due to its vague symptomatology, it is mainly regarded as a diagnosis of exclusion. Patients can often be misdiagnosed for several years before a correct diagnosis is established, also due to a medical team's clinical suspicion. We present a case series of two patients who suffered from MALS and were treated successfully. The first patient is a 32-year-old woman, presenting with post-prandial abdominal pain and weight loss that have lasted for the past ten years. The second patient, a 50-year-old woman, presented with similar symptomatology, with the symptoms lasting for the last five years. Both cases were treated by laparoscopic division of the median arcuate ligament fibers, which alleviated extrinsic pressure from the celiac artery. Previous cases of MALS were retrieved from PubMed, to assemble a better diagnostic algorithm and propose a treatment method of choice. The literature review suggests an angiography with a respiratory variation protocol as the diagnostic modality of choice, along with the laparoscopic division of the median arcuate ligament fibers as the proposed treatment of choice. Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interests for this article. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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