TY - JOUR
AR - SCR-2019-2-112
TI - Mini-invasive treatment of median arcuate ligament syndrome, a case report
AU - Angelica , Ganss
AU - Angelo , Marzullo
AU - Irene , Spilimbergo
AU - Marcodomenico , Mazza
AU - Mariangela , Ruperto
AU - Marzia , Riccardo
AU - Maurizio , Balduino
AU - Maurizio De , Luca
AU - Nicola , Passuello
JO - Surgical Case Reports
PY - 2019
DA - Thu 23, May 2019
SN - 2613-5965
DO - http://dx.doi.org/10.31487/j.SCR.2019.02.012
UR - https://www.sciencerepository.org/mini-invasive-treatment-of-median-arcuate-ligament-syndrome-a-case-report_SR-SCR-2019-2-112 
KW - Median arcuat ligament, Dunbar syndrome, celiac trunk, abdominal pain, laparoscopy
AB - Introduction: Median arcuate ligament syndrome (MALS), also known as Dunbar syndrome or celiac
artery compression syndrome, is a rare disorder due to external compression of the celiac trunk (CT) by the
median arcuate ligament (MAL). The diagnosis is difficult and often one of exclusion, because of its
nonspecific symptoms that overlap with other forms of chronic intestinal ischemia. Laparoscopic approach
is considered to be an optimal therapeutic option.
Material and Surgical Techniques: We describe the case of a 40-year-old woman who presented with a 4
years-long clinical history of postprandial abdominal pain, occasional vomiting and severe weight loss in
the last year. An abdominal CT scan demonstrated an external compression of the CT and the patient
underwent laparoscopic decompression by division of the MAL. Postoperative course was uneventful and
the patient was discharged on the 5th postoperative day.
Discussion: Despite being MALS a rare disease, it must be kept in the differential diagnosis of abdominal
pain. Diagnosis is difficult and often requires 2nd level investigations. Laparoscopy can be useful both as a
diagnostic and curative approach. The laparoscopic division of the MAL is a feasible and safe procedure,
leading to an improved quality of life.