What is Median Arcuate Ligament Syndrome?
Median arcuate ligament syndrome occurs when the celiac artery is kinked or compressed by the median arcuate ligament which is part of the muscles of the diaphragm. Initial testing uses duplex ultrasound. During inspiration the artery is straight. During expiration the artery becomes kinked which decreased blood flow to parts of the digestive system. There is a reasonable portion of the population who may have this syndrome radiologically without any symptoms. These people do not need any treatment.
What are the symptoms?
Patients with median arcuate ligament syndrome are often young and usually female. They have difficulty eating, abdominal pain after eating, will often vomit very shortly after eating. These patients can develop a progressive aversion to food and weightloss.
How is it treated?
Median arcuate ligament syndrome is a diagnosis of exclusion. That means that prior to making this diagnosis a patient should be thoroughly examined for more common ailments such as gallbladder disease or gastroesophageal reflux disease. Once common things are ruled out and if the ultrasound or other diagnostic tests are consistent with the syndrome surgery to divide the median arcuate ligament and nerves surrounding the celiac artery is performed. This surgery can be done laparoscopically or in an open fashion.
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