| Popis: |
Median arcuate ligament syndrome (MALS) is a frequent differential diagnosis in patients with post-prandial abdominal symptoms, but diagnosis remains challenging. The aim of this study was to identify characteristics of patients who had MALS compared to non-MALS patients amongst a cohort of patients diagnosed with celiac artery compression (CAC).An IRB approved retrospective chart review (2000-2021) of patients at our institution with a discharge diagnosis of CAC was performed. Medical record review for clinical symptoms and findings consistent with MALS was performed.293 patients with a diagnosis of CAC were identified. 59.7% were female and average age was 63.9 ± 20.2 years. 69 (23.5%) patients with CAC had MALS. There were no significant differences in sex or race between MALS and non-MALS patients, but MALS patients were younger (55.7 vs 68.1, p0.001). There was no significant difference in gastrointestinal comorbidities between the two groups. Patients with MALS were less likely to have diabetes (12.5% vs. 26.9%), renal disease (4.6% vs 8.2%) and hypertension (41.5% vs. 70.3%), mesenteric atherosclerotic disease (14% vs 61.9%) and peripheral artery disease (15.0% vs 39.7%).We demonstrate a novel observation that MALS patients tend to have less atherosclerotic characteristics than non-MALS patients with CAC. Patients in our study with MALS were more likely to be younger, female, and presenting with epigastric pain. MALS patients had a significantly lower incidence of diabetes, hypertension, renal disease, mesenteric artery disease and peripheral arterial disease compared to the non-MALS group. An important clinically relevant feature of MALS patients may be their lack of atherosclerotic phenotype compared with non- MALS patients with CAC. |
