The laparoscopic approach in the median arcuate ligament syndrome: A case report

Emanuele Baldassarre, Giovanni Torino, Andrea Siani, Marco Barone, Gabriele Volenti

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

A malposition of the median arcuate ligament (MAL) is a rare entity causing the celiac axis compression syndrome (CACS), first described by Harjola in 1963. The presence of anomalous fibrous diaphragmatic bands of the diaphragm compresses the celiac axis, especially during the expiration. In this report we present the fourth case in literature that was ever successfully treated by laparoscope A 38-year-old male presented with a history of intermittent epigastric pain, 15 kg weight loss caused by inappetence and frequent diarrhoea, over a 5-year period. The clinical examination revealed only a loud systolic bruit in the epigastrium, with loss of intensity during deep inspiration. Suspecting CACS, a spiral CT angiography was requested. The CT demonstrated the MAL crossing anteriorly to the celiac artery (CA) and the sagittal and the tridimensional reconstructions demonstrated the CA narrowing due to compression, while the superior mesenteric artery (SMA) was normal. The MAL was laparoscopically divided, releasing the celiac axis. The surgical time was 130 minutes, without significant blood losses. At 3-months follow-up, the CT-scan demonstrated no evidence of CACS with complete recovery.

Original languageEnglish
Pages (from-to)353-354
Number of pages2
JournalSwiss Medical Weekly
Volume137
Issue number23-24
Publication statusPublished - Jun 16 2007

Fingerprint

Abdomen
Ligaments
Celiac Artery
Laparoscopes
Superior Mesenteric Artery
Spiral Computed Tomography
Operative Time
Diaphragm
Weight Loss
Diarrhea
Celiac Artery Stenosis from Compression by Median Arcuate Ligament of Diaphragm
Pain

Keywords

  • Celiac axis compression syndrome
  • Malposition
  • Median arcuate ligament

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Baldassarre, E., Torino, G., Siani, A., Barone, M., & Volenti, G. (2007). The laparoscopic approach in the median arcuate ligament syndrome: A case report. Swiss Medical Weekly, 137(23-24), 353-354.

The laparoscopic approach in the median arcuate ligament syndrome : A case report. / Baldassarre, Emanuele; Torino, Giovanni; Siani, Andrea; Barone, Marco; Volenti, Gabriele.

In: Swiss Medical Weekly, Vol. 137, No. 23-24, 16.06.2007, p. 353-354.

Research output: Contribution to journalArticle

Baldassarre, E, Torino, G, Siani, A, Barone, M & Volenti, G 2007, 'The laparoscopic approach in the median arcuate ligament syndrome: A case report', Swiss Medical Weekly, vol. 137, no. 23-24, pp. 353-354.
Baldassarre E, Torino G, Siani A, Barone M, Volenti G. The laparoscopic approach in the median arcuate ligament syndrome: A case report. Swiss Medical Weekly. 2007 Jun 16;137(23-24):353-354.
Baldassarre, Emanuele ; Torino, Giovanni ; Siani, Andrea ; Barone, Marco ; Volenti, Gabriele. / The laparoscopic approach in the median arcuate ligament syndrome : A case report. In: Swiss Medical Weekly. 2007 ; Vol. 137, No. 23-24. pp. 353-354.
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