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

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 misdi...

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Autores principales: Giakoustidis, Alexandros, Moschonas, Stavros, Christodoulidis, Gregory, Chourmouzi, Danae, Diamantidou, Anna, Masoura, Sophia, Louri, Eleni, Papadopoulos, Vasileios N, Giakoustidis, Dimitrios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315115/
https://www.ncbi.nlm.nih.gov/pubmed/37405099
http://dx.doi.org/10.4240/wjgs.v15.i6.1048
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author Giakoustidis, Alexandros
Moschonas, Stavros
Christodoulidis, Gregory
Chourmouzi, Danae
Diamantidou, Anna
Masoura, Sophia
Louri, Eleni
Papadopoulos, Vasileios N
Giakoustidis, Dimitrios
author_facet Giakoustidis, Alexandros
Moschonas, Stavros
Christodoulidis, Gregory
Chourmouzi, Danae
Diamantidou, Anna
Masoura, Sophia
Louri, Eleni
Papadopoulos, Vasileios N
Giakoustidis, Dimitrios
author_sort Giakoustidis, Alexandros
collection PubMed
description 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.
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spelling pubmed-103151152023-07-03 Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience Giakoustidis, Alexandros Moschonas, Stavros Christodoulidis, Gregory Chourmouzi, Danae Diamantidou, Anna Masoura, Sophia Louri, Eleni Papadopoulos, Vasileios N Giakoustidis, Dimitrios World J Gastrointest Surg Minireviews 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. Baishideng Publishing Group Inc 2023-06-27 2023-06-27 /pmc/articles/PMC10315115/ /pubmed/37405099 http://dx.doi.org/10.4240/wjgs.v15.i6.1048 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Minireviews
Giakoustidis, Alexandros
Moschonas, Stavros
Christodoulidis, Gregory
Chourmouzi, Danae
Diamantidou, Anna
Masoura, Sophia
Louri, Eleni
Papadopoulos, Vasileios N
Giakoustidis, Dimitrios
Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience
title Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience
title_full Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience
title_fullStr Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience
title_full_unstemmed Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience
title_short Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience
title_sort median arcuate ligament syndrome often poses a diagnostic challenge: a literature review with a scope of our own experience
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315115/
https://www.ncbi.nlm.nih.gov/pubmed/37405099
http://dx.doi.org/10.4240/wjgs.v15.i6.1048
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