6533b860fe1ef96bd12c2f76

RESEARCH PRODUCT

Median arcuate ligament syndrome, a rare case of chronic abdominal pain

Fania PucciaRoberto CitarrellaFilippo Alessandro MontaltoLuigi MirarchiAntonino TerranovaAntonietta SerrutoRoberto CitarrellaGiuseppe Lo ReMaurizio Soresi

subject

Abdominal painmedicine.medical_specialtySettore MED/09 - Medicina InternaMedian arcuate ligament syndromelcsh:MedicineCeliac arterymedicine.arterymedicineComputed tomography angiographymedicine.diagnostic_testultrasoundbusiness.industryMedicine (all)Median arcuate ligamentlcsh:RDopplerabdominal painGeneral Medicinemedicine.diseaseStenosismedicine.anatomical_structureceliac artery compression syndromeAbdomenDoppler.Radiologymedicine.symptombusinessMedian arcuate ligament syndromeRare disease

description

The median arcuate ligament syndrome (MALS) is a rare disease characterized by abdominal pain caused by the external compression of the celiac artery by the median arcuate ligament. Surgical treatment is indicated, but given the non-specific symptoms, these patients are often hospitalized in the Departments of Internal Medicine where the diagnosis may be unknown. We present a case of MALS admitted to our Internal Medicine Division. An abdominal ultrasound in a woman with longstanding abdominal pain showed elevated celiac artery velocities during forced expiration. Computed tomography angiography (CTA) of the abdomen showed stenosis of the origin of the celiac artery and confirmed the diagnosis of MALS. MALS is a syndrome that has to be considered, especially in young women with abdominal pain of unclear etiology; evaluated by color Doppler ultrasound, in the presence of elevated hepatic artery velocities during forced expiration, the confirmatory test is CTA.

https://doi.org/10.4081/itjm.2018.1041