Although results of surgical treatment will be discussed in Chap. 30, one of the key factors to consider before embarking on open median arcuate ligament (MAL) release is the potential outcomes based on symptoms, patient age, associated comorbidities, and preoperative assessment. Reilly et al. demonstrated that patients with atypical pain patterns, age greater than 60 years old, weight loss less than 20 lbs, and a history of psychiatric disease or alcohol abuse were less likely to improve after MAL release. The patient and surgeon should have a frank discussion regarding the difficulty in predicting postoperative outcomes after MAL release, particularly because of the wide overlap of symptoms of MAL syndrome (MALS) with other gastrointestinal and intra-abdominal pathologies.
Median arcuate ligament syndrome Open median arcuate ligament release Ganglion resection Percutaneous transluminal angioplasty of chronic mesenteric ischemia Celiac compression
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