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 language | English |
|---|---|
| Pages (from-to) | 353-354 |
| Number of pages | 2 |
| Journal | Swiss Medical Weekly |
| Volume | 137 |
| Issue number | 23-24 |
| Publication status | Published - Jun 16 2007 |
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Keywords
- Celiac axis compression syndrome
- Malposition
- Median arcuate ligament
ASJC Scopus subject areas
- Medicine(all)
Cite this
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 journal › Article
}
TY - JOUR
T1 - The laparoscopic approach in the median arcuate ligament syndrome
T2 - A case report
AU - Baldassarre, Emanuele
AU - Torino, Giovanni
AU - Siani, Andrea
AU - Barone, Marco
AU - Volenti, Gabriele
PY - 2007/6/16
Y1 - 2007/6/16
N2 - 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.
AB - 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.
KW - Celiac axis compression syndrome
KW - Malposition
KW - Median arcuate ligament
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UR - http://www.scopus.com/inward/citedby.url?scp=34447335868&partnerID=8YFLogxK
M3 - Article
C2 - 17629806
AN - SCOPUS:34447335868
VL - 137
SP - 353
EP - 354
JO - Swiss Medical Weekly
JF - Swiss Medical Weekly
SN - 1424-7860
IS - 23-24
ER -