Median Arcuate Ligament Syndrome in a patient with Crohn's disease

https://doi.org/10.1016/j.ijscr.2013.01.015Get rights and content
Under a Creative Commons license
open access

Abstract

INTRODUCTION

The Median Arcuate Ligament Syndrome is a rare condition characterized by postprandial abdominal pain, bowel function disorder and weight loss. We report the first case to our knowledge of Crohn's disease and Median Arcuate Ligament Syndrome.

PRESENTATION OF CASE

The patient was a 33 year-old female with a previous diagnosis of Crohn's disease. Acute postprandial abdominal pain affected the patient every day; she was, therefore, referred to US-Doppler and magnetic resonance angiography of the abdominal vessels and received a diagnosis of Median Arcuate Ligament Syndrome. Consequently, the patient was surgically treated, releasing the vascular compression. After the operation, she reported a complete relief from postprandial pain which was one of her major concerns. Subocclusive symptoms occurred after six months due to the inflammatory reactivation of the terminal ileitis.

DISCUSSION

The diagnosis of Median Arcuate Ligament Syndrome is mainly based on the exclusion of other intestinal disorders but it should be always confirmed using noninvasive tests such as US-Doppler, angio-CT or magnetic resonance angiography.

CONCLUSION

This case demonstrates that the Median Arcuate Ligament Syndrome could be the major cause of symptoms, even in presence of other abdominal disorders.

Abbreviations

MALS
Median Arcuate Ligament Syndrome
MAL
Median Arcuate Ligament
CD
Crohn's disease
CT
computerized tomography
MRA
magnetic resonance angiography
US
ultra-sonography
WBC
white blood cells
ESR
erythrocyte sedimentation rate

Keywords

Median Arcuate Ligament Syndrome
Dunbar's Syndrome
Crohn's disease

Cited by (0)