Hussen Md Deluwar, Tabassum Zareen, Jenny Anawara Afroz, Naharin Kashfia, Khanam Farjana
Dinajpur Medical College, Dinajpur, Bangladesh.
Ad-din Sakina Medical College and Hospital, Jashore, Bangladesh.
Radiol Case Rep. 2025 Apr 12;20(7):3261-3266. doi: 10.1016/j.radcr.2025.03.021. eCollection 2025 Jul.
The disorder median arcuate ligament syndrome (MALS) develops when the median arcuate ligament compresses the celiac artery and accompanying nerve fibers leading to postprandial abdominal pain, nausea and bloating symptoms that are commonly mistaken for other gastrointestinal or vascular conditions. A 29-year-old female patient experienced right hypochondrium pain after eating combined with burning stomach pain and debilitating bloating episodes for 5 months. Computed tomography (CT) angiography scan and Doppler ultrasonography revealed celiac artery stenosis due to pressure from the median arcuate ligament along with cholelithiasis. The patient's vague symptoms illustrate the diagnostic difficulty of MALS patients who also have cholelithiasis and demonstrates how CT and Doppler ultrasonography serve crucially to validate MALS diagnosis. Surgical treatment of the median arcuate ligament by physical release has proved successful in treating symptoms despite patients also having cholelithiasis. Early detection and surgical treatment can increase favorable outcomes for patients with such rare conditions.
当正中弓状韧带压迫腹腔干动脉及伴行神经纤维时,就会引发一种病症——正中弓状韧带综合征(MALS),进而导致餐后腹痛、恶心和腹胀等症状,这些症状常被误诊为其他胃肠道或血管疾病。一名29岁女性患者在进食后出现右季肋部疼痛,并伴有胃部灼痛和严重的腹胀发作,持续了5个月。计算机断层扫描(CT)血管造影扫描和多普勒超声检查显示,腹腔干动脉因正中弓状韧带的压迫而狭窄,同时伴有胆结石。该患者的模糊症状说明了患有胆结石的MALS患者的诊断难度,也展示了CT和多普勒超声检查在确诊MALS方面的关键作用。尽管患者同时患有胆结石,但通过物理松解对正中弓状韧带进行手术治疗已被证明在缓解症状方面是成功的。早期发现和手术治疗可以提高此类罕见病症患者的良好预后。