Laparoscopic Median Arcuate Ligament Release

Richard M Peterson, MD MPH, Stephen J Fenton, MD. University of Texas Health Science Center San Antonio; Wilford Hall Medical Center

 

Median Arcuate Ligament Syndrome (also known as Celiac Artery Compression Syndrome) was first described in 1963.  There are very few series in the literature with most published work as case reports.  The success of the surgical approach varies widely ranging from 53-93%.  We offer a case of a 34-year-old female that presented with a 6-month history of abdominal pain and accompanied weight loss (25 lbs). Her complaints of pain were left sided and associated with position as well as 30-60 minutes following meals. After a thorough workup she was found by CT scan to have compression of her celiac artery from her median arcuate ligament. After consultation with the vascular surgery service she was offered a laparoscopic release of her median arcuate ligament. Identification of the celiac artery was undertaken and careful dissection of the celiac trunk was completed. The fibers of the celiac plexus were dissected and entirely transected. The median arcuate ligament was divided. The patient tolerated the procedure well. By the evening of surgery she was tolerating a liquid diet. By post operative day 1 she was eating a regular diet with no complaints of abdominal pain after eating or with position. At her 1-month visit she had gained 5 lbs (weight 110 lbs) and was able to exercise without complaints of abdominal pain. At her 3-month visit she had gained a total of 14 lbs (weight 119 lbs) and remained pain free.


Session Number: SS21 – Videos: Solid Organ & Foregut
Program Number: V041

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