Median Arcuate Ligament Syndrome and Its Associated Conditions

The risk factors and associated conditions of median arcuate ligament syndrome (MALS) have not been well characterized in the literature. In this study, we aim to investigate the presentation and outcomes of MALS patients with an emphasis on the prevalence of other uncommon disorders. To this end, d...

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Bibliographic Details
Published in:The American surgeon 2019-10, Vol.85 (10), p.1162-1165
Main Authors: Huynh, Desmond T. K., Shamash, Kevin, Burch, Miguel, Phillips, Edward, Cunneen, Scott, Van Allan, Richard J., Shouhed, Daniel
Format: Article
Language:English
Subjects:
Abnormalities
Cardiac arrhythmia
Connective tissues
Disorders
Ehlers-Danlos syndrome
Emptying
Gastric emptying
Ischemia
Ligaments
Medical imaging
Nuclear medicine
Pain
Patients
Population
Posture
Risk analysis
Risk factors
Studies
Surgery
Tachycardia
Ultrasonic imaging
Velocity
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Summary:The risk factors and associated conditions of median arcuate ligament syndrome (MALS) have not been well characterized in the literature. In this study, we aim to investigate the presentation and outcomes of MALS patients with an emphasis on the prevalence of other uncommon disorders. To this end, data of patients with MALS who underwent surgery between 2013 and 2018 were collected and compiled into a retrospective database and analyzed. Eleven patients were identified. Seven of these eleven patients underwent diagnostics to evaluate gastric emptying. Five of these seven patients (71.4%) had radiographic evidence of delayed gastric emptying. Four of the eleven patients (36.4%) were found to have anatomic abnormalities of their visceral vasculature. Two of the eleven patients (18.2%) were found to have connective tissue disorders, both with Ehlers-Danlos syndrome. Three of the eleven (27.3%) had a diagnosis of postural orthostatic tachycardia syndrome. This is the first case series reporting on an association between MALS and delayed gastric emptying. We also explored the relationship between MALS and visceral vascular abnormalities, Ehlers-Danlos syndrome, and postural orthostatic tachycardia syndrome. It is notable that these conditions are more prevalent in the MALS population than in the general population, suggesting a possible pathophysiologic relationship.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481908501019