Median arcuate ligament syndrome--a novel treatment using an intrathecal morphine pump to relieve intractable visceral pain.
OBJECTIVE
Median arcuate ligament syndrome, which presents with intractable visceral pain, is difficult to both diagnose and treat. This case report describes the first use of an intrathecal morphine pump as an effective therapeutic intervention.


METHODS
We describe a 39-year-old female who presented with a four-year history of misdiagnosed debilitating abdominal pain. After multiple failed attempts at medical management and surgeries, a trial of intrathecal narcotics provided significant relief. Six months after insertion of an intrathecal morphine pump, the patient was pain-free and had resumed all activities of daily living.


CONCLUSIONS
The use of an intrathecal narcotic pump should be considered for treatment of patients with intractable visceral pain secondary to median arcuate ligament syndrome.
Guttman
Oren T
OT
Department of Anesthesiology and Pain Medicine, The Mount Sinai School of Medicine, New York, New York 10029, USA. oren.guttman@mssm.edu
Rosenblatt
Meg A
MA
Mims
Timothy
T
D015746:Abdominal Pain / Q000628:therapy*; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D009020:Morphine / Q000008:administration & dosage*; D010147:Pain Measurement; D010148:Intractable Pain / Q000628:therapy*; D013116:Spinal Cord / Q000502:physiology / Q000528:radiation effects
D000701:Analgesics, Opioid; D009020:Morphine