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Open Surgical Treatment

  • Audra A. DuncanEmail author
Chapter

Abstract

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.

Keywords

Median arcuate ligament syndrome Open median arcuate ligament release Ganglion resection Percutaneous transluminal angioplasty of chronic mesenteric ischemia Celiac compression 

References

  1. 1.
    Reilly LM, Ammar AD, Stoney RJ, Ehrenfeld WK. Late results following operative repair for celiac artery compression syndrome. J Vasc Surg. 1985;2:79–91.PubMedCrossRefGoogle Scholar
  2. 2.
    Duncan AA. Median arcuate ligament syndrome. Curr Treatment Options in Cardiovasc Med. 2008;10:112–6.CrossRefGoogle Scholar
  3. 3.
    Balaban DH, Chen J, Lin Z, et al. Median arcuate ligament syndrome: a possible cause of idiopathic gastroparesis. Am J Gastroenterol. 1997;92:519–23.PubMedGoogle Scholar
  4. 4.
    Desmond CP. Exercise-related abdominal pain as a manifestation of the median arcuate ligament syndrome. Scand J Gastroenterol. 2004;39:1310–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Saddekni S, Sniderman KW, Hilton S, Sos TA. Percutaneous transluminal angioplasty of nonatherosclerotic lesions. AJR Am J Roentgenol. 1980;135:975–82.PubMedCrossRefGoogle Scholar
  6. 6.
    Matsumoto AH, Tegtmeyer CJ, Fitzcharles EK, et al. Percutaneous transluminal angioplasty of visceral arterial stenosis: results and long-term clinical follow-up. J Vasc Interv Radiol. 1995;6:165–74.PubMedCrossRefGoogle Scholar
  7. 7.
    Matsumoto AH, Angle JF, Spinosa DJ, et al. Percutaneous transluminal angioplasty and stenting in the treatment of chronic mesenteric ischemia: results and long-term follow-up. J Am Coll Surg. 2002;194(1 Suppl):S22–31.PubMedCrossRefGoogle Scholar
  8. 8.
    Cina CS, Safar H. Successful treatment of recurrent celiac axis compression syndrome. A case report. Panminerva Med. 2002;44:69–72.PubMedGoogle Scholar
  9. 9.
    Jimenez JC, Harlander-Locke M, Dutson EP. Open and laparoscopic treatment of median arcuate ligament syndrome. J Vasc Surg. 2012;56:869–73.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Vascular and Endovascular Surgery, Department of SurgeryMayo ClinicRochesterUSA

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