Sun Zhuo, Fritz David A, Turner Suzanne, Hardy David M, Meiler Steffen E, Martin Dan C, Dua Anterpreet
From the Departments of Anesthesiology and Perioperative Medicine.
Vascular Surgery.
A A Pract. 2018 Aug 1;11(3):76-78. doi: 10.1213/XAA.0000000000000743.
Median arcuate ligament syndrome (MALS), also known as celiac artery compression syndrome, is an uncommon condition classically characterized by chronic abdominal pain, weight loss, and abdominal bruit. Chronic mesenteric ischemia caused by intermittent compression of the celiac artery by the MAL provokes upper abdominal pain that is sympathetically mediated via the celiac plexus. Because it is a diagnosis of exclusion, diagnosis of MALS in the clinical setting is typically challenging. We present an atypical case which highlights the utility of celiac plexus block as both an assistant diagnostic tool and a predictor of surgical outcomes for suspected MALS.
正中弓状韧带综合征(MALS),也称为腹腔干压迫综合征,是一种罕见疾病,典型表现为慢性腹痛、体重减轻和腹部杂音。正中弓状韧带间歇性压迫腹腔干导致的慢性肠系膜缺血引发上腹部疼痛,该疼痛通过腹腔神经丛由交感神经介导。由于它是一种排除性诊断,在临床环境中诊断MALS通常具有挑战性。我们展示了一个非典型病例,该病例突出了腹腔神经丛阻滞作为疑似MALS的辅助诊断工具和手术结果预测指标的效用。