title: Laparoscopic treatment for median arcuate ligament syndrome:  the usefulness of intraoperative Doppler ultrasound to confirm the decompression of the celiac artery.
abstract: The median arcuate ligament syndrome is an unusual disease associated with postprandial epigastric pain, and the optimal treatment of this syndrome remains to be established. A 52-year-old woman manifested in our hospital postprandial epigastric pain, and extrinsic compression of the celiac trunk revealed by an abdominal computed tomography. After the induction of general anesthesia, the celiac artery origin was completely skeletonized using a laparoscopic dissector and vessel sealing system. Intraoperative Doppler ultrasound demonstrated that, after surgery, the stenosis of the celiac artery, and poststenotic dilatation observed before the release of the median arcuate ligament, had completely disappeared. In conclusion, the laparoscopic release of the median arcuate ligament is a minimally invasive treatment for median arcuate ligament syndrome. The intraoperative Doppler ultrasound is useful for confirming the decompression of the celiac artery, although long-term follow-up is mandatory.
authors.affiliation: Department of Surgery, National Defense Medical College, Namiki, Tokorozawa, Japan. tsujihi@ndmc.ac.jp
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsujimoto
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hiraki
authors.forename: Naoko
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yaguchi
authors.forename: Isao
authors.initials: I
authors.lastname: Kumano
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Akase
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horiguchi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ono
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hase
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008022:Ligaments / Q000601:surgery*; D008875:Middle Aged; D019518:Postprandial Period; D013577:Syndrome; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler