title: [Laparoscopic treatment of median arcuate ligament syndrome (MALS) -- case report].
abstract: METHODS
  The authors report a case of a 34-year-old woman who had postprandial abdominal pain for years. During the course of her examination lactose intolerance and hiatus hernia was diagnosed. After ineffective conservative treatment CT angiography (CTA) and digital substraction angiography (DSA) was performed and showed significant celiac artery stenosis. Percutaneous transluminal angioplasty (PTA) was unsuccessful as extravasal mechanical compression was present, therefore, laparoscopic decompression and surgical division of MAL fibres were carried out. The postoperative period was characterized by a complete relief of previous symptoms and repeated CTA showed normal blood flow.
  
  
  CONCLUSIONS
  The authors emphasize the importance of the measurement of peak velocity of celiac trunk with Colour Duplex abdominal ultrasonography, the examination has 100% sensitivity and 83% specificity. The Duplex ultrasonography is less expensive than the "gold standard" diagnostic methods like CT and DS angiography, and can lead us to early diagnosis. Laparoscopic surgery is safe and low expense method for celiac artery decompression, however, sometimes it is difficult to reveal the exact reason and thus setting up the proper operation plan.
authors.affiliation: Semmelweis Egyetem II. Sz. Sebészeti Klinika Budapest.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schöller
authors.affiliation: Semmelweis Egyetem II. Sz. Sebészeti Klinika Budapest.
authors.forename: István
authors.initials: I
authors.lastname: Sugár
authors.affiliation: Semmelweis Egyetem Érsebészeti Tanszék Budapest.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szeberin
authors.affiliation: Semmelweis Egyetem II. Sz. Sebészeti Klinika Budapest.
authors.forename: Pál
authors.initials: P
authors.lastname: Ondrejka
authors.affiliation: Semmelweis Egyetem II. Sz. Sebészeti Klinika Budapest.
authors.forename: Gábor
authors.initials: G
authors.lastname: István
authors.affiliation: Semmelweis Egyetem II. Sz. Sebészeti Klinika Budapest Magyar Honvédség Egészségügyi Központ I. Sz. Sebészeti Osztály Budapest.
authors.forename: Attila
authors.initials: A
authors.lastname: Vörös
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002445:Celiac Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D003251:Constriction, Pathologic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D000074742:Median Arcuate Ligament Syndrome; D019518:Postprandial Period; D018616:Ultrasonography, Doppler, Duplex / Q000191:economics; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Color Duplex ultrasonography; MALS; angiographia; angiography; duplex ultrahang; truncus coeliacus compressiós szindróma