Journal on Recent Advances in Pain

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VOLUME 4 , ISSUE 3 ( September-December, 2018 ) > List of Articles

CASE REPORT

Median Arcuate Ligament Syndrome: A Rare Cause of Epigastric Pain

Sushma Pandey, Sachin Khanduri, Vivek K Yadav, Harsh Yadav, Ekta Tyagi

Keywords : Celiac artery compression syndrome, Epigastric pain, Median arcuate ligament syndrome, Radiology

Citation Information : Pandey S, Khanduri S, Yadav VK, Yadav H, Tyagi E. Median Arcuate Ligament Syndrome: A Rare Cause of Epigastric Pain. J Recent Adv Pain 2018; 4 (3):112-114.

DOI: 10.5005/jp-journals-10046-0121

License: CC BY-NC 4.0

Published Online: 01-12-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Aim: To diagnose and aid the treatment of a patient with an unknown cause of epigastric pain. Background: Harjola first described median arcuate ligament syndrome (aka celiac artery compression syndrome) in 1963. Typically it occurs in young patients (20–40 years age group) and is more common in lean women, presents with epigastric pain and weight loss. Case description: An 18-year-old male visited the emergency room with a complaint of recurrent episodes of abdominal pain. There was no past or any medical history of any previous illness. On physical examination, the patient was afebrile and had pallor. All the vitals were within normal limits. The abdominal examination did not reveal any significant abnormality. Laboratory investigations (Hb, GBP, TLC) were within normal limits. Conclusion: Median arcuate ligament syndrome is a rare clinical entity which can be found in normal asymptomatic people. In a few cases, however, celiac axis compression can cause symptoms which can be relieved with laparoscopic surgical decompression. Clinical significance: The median arcuate ligament syndrome as an entity must be kept in mind when no other cause of abdominal pain is zeroed on even after all the clinical examinations and investigations.


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  1. Harjola PT. A rare obstruction of the coeliac artery. Report of a case. Ann Chir Gynaecol Fenn. 1963;52:547-550.
  2. Lindner HH, Kemprud E. A clinicoanatomical study of the arcuate ligament of the diaphragm. Archives of Surgery. 1971 Nov 1;103(5):600-605.
  3. Szilagyi DE, Rian RL, Elliott JP, Smith RF. The celiac artery compression syndrome: does it exist?. Surgery. 1972 Dec 1;72(6):849-863.
  4. Bron KM, Redman HC. Splanchnic artery stenosis and occlusion: incidence; arteriographic and clinical manifestations. Radiology. 1969 Feb;92(2):323-328.
  5. Sproat IA, Pozniak MA, Kennell TW. US case of the day: median arcuate ligament syndrome. Radio Graphics 1993;13:1400-1402.
  6. Roayaie S, Jossart G, Gitlitz D, Lamparello P, Hollier L, Gagner M. Laparoscopic release of celiac artery compression syndrome facilitated by laparoscopic ultrasound scanning to confirm restoration of flow. Journal of vascular surgery. 2000 Oct 1;32(4):814-817.
  7. Takach TJ, Livesay JJ, Reul GJ Jr, Cooley DA. Celiac compression syndrome: tailored therapy based on intraoperative .ndings. J Am Coll Surg 1996;183:606-610.
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