Okobi Okelue E, Afuda Belinda A, Boms Maureen, Ekpemiro Chinwendum U, Umeh Nneka J, Nnaji Chukwudike G, Onyechi Nkemputaife P, Faderin Oluwatobi G, Chiji-Aguma Jennifer C, Stephen Eboigbe, Amadi Clifford O
Family Medicine, Lakeside Medical Center, Belle Glade, USA.
Family Medicine, Humber River Hospital, Toronto, CAN.
Cureus. 2022 Sep 7;14(9):e28889. doi: 10.7759/cureus.28889. eCollection 2022 Sep.
Pain, nausea, vomiting, weight loss, diarrhea, and fatigue are common symptoms of several upper gastroenterological illnesses. However, the presence of unexplained recurring postprandial abdominal pain and vomiting increases the possibility of median arcuate ligament syndrome (MALS). MALS is an uncommon illness characterized by postprandial vomiting, abdominal pain, and weight loss. The compression of the median arcuate ligament on the celiac trunk and/or its surrounding celiac nerve plexus may explain this disease phenomenon. Comprehensive workup for other etiologies may be unrevealing except for the compression of the celiac trunk identified in imaging studies and, perhaps, occasional arterial flow rates in sonography studies in some severe cases. Due to the overlapping symptoms of upper gastroenterological disorders, misdiagnosis may be widespread. Therefore, it is essential to consider MALS while examining a patient with upper gastrointestinal disease. In this case series, we present two cases of MALS with similar clinical trajectories and differences in diagnostic techniques.
疼痛、恶心、呕吐、体重减轻、腹泻和疲劳是几种上消化道疾病的常见症状。然而,不明原因的反复发作的餐后腹痛和呕吐会增加正中弓状韧带综合征(MALS)的可能性。MALS是一种罕见疾病,其特征为餐后呕吐、腹痛和体重减轻。正中弓状韧带对腹腔干和/或其周围腹腔神经丛的压迫可能解释了这种疾病现象。除了影像学研究中发现的腹腔干受压情况,以及在某些严重病例的超声检查中偶尔出现的动脉血流速度外,对其他病因进行全面检查可能并无结果。由于上消化道疾病症状重叠,误诊可能很普遍。因此,在检查患有上消化道疾病的患者时,考虑MALS至关重要。在本病例系列中,我们呈现了两例具有相似临床病程和诊断技术差异的MALS病例。