Allende Sanatorium. Córdoba (Argentina).
Cir Pediatr. 2021 Jan 1;34(1):47-50.
Median arcuate ligament syndrome, which is characterized by postprandial pain, occurs as a result of the compression of the celiac trunk by the ligament. It is a rare pathology in pediatric patients. We present the case of a 14-year-old girl with recurrent abdominal pain. Ultrasound examination showed an increase in celiac trunk flow rate with flow reversal, while CT angiography demonstrated compression. It was surgically managed by dividing the arcuate ligament through videolaparoscopy. Symptoms disappeared right after surgery and did not reappear in the 24-month follow-up. The arcuate ligament is a fibrous band located at the level of the diaphragmatic crus. The fact that the celiac trunk originates at the supradiaphragmatic aorta makes the ligament exert compression during expiration, with transitory distal ischemia. Diagnosis is achieved through Doppler ultrasonography of the celiac trunk or CT angiography, among others. Surgical management involves dividing the arcuate ligament. This syndrome should be considered in the presence of recurrent abdominal pain. The laparoscopic route is the treatment approach suggested.
中位弓状韧带综合征，其特征是餐后疼痛，是由韧带压迫腹腔干引起的。它在儿科患者中是一种罕见的疾病。我们报告了一例 14 岁女孩反复腹痛的病例。超声检查显示腹腔干血流速度增加，伴有血流逆转，而 CT 血管造影显示有压迫。通过腹腔镜手术将弓状韧带切开进行治疗。手术后症状立即消失，在 24 个月的随访中没有再次出现。弓状韧带是位于膈肌脚水平的纤维带。由于腹腔干起源于膈上主动脉，因此韧带在呼气时会施加压力，导致短暂的远端缺血。通过腹腔干多普勒超声或 CT 血管造影等检查可确诊。手术治疗包括切开弓状韧带。在存在反复腹痛时应考虑这种综合征。腹腔镜途径是建议的治疗方法。
