{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:39:33Z","timestamp":1774611573590,"version":"3.50.1"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T00:00:00Z","timestamp":1397174400000},"content-version":"vor","delay-in-days":100,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n INTRODUCTION:<\/jats:title>\n Median arcuate ligament syndrome (MALS), a condition of poorly understood etiology, is caused by compression of the celiac artery by fibers of the median arcuate ligament.<\/jats:p>\n <\/jats:sec>\n \n PRESENTATION OF CASE:<\/jats:title>\n A 46-year-old man with chronic abdominal pain and weight loss was diagnosed with MALS and admitted for surgery. During surgery, extensive retroperitoneal fibrosis around the celiac artery and adjacent aorta was noted. Large necrotizing granulomas and budding yeast, both indicators of histoplasmosis, were found on pathologic evaluation of retroperitoneal tissue removed during surgery.<\/jats:p>\n <\/jats:sec>\n \n DISCUSSION:<\/jats:title>\n Histoplasma capsulatum may cause pulmonary fibrosis and fibrosing mediastinitis, and the organism may disseminate to reach various internal organs in the immunocompromised individual. Retroperitoneal histoplasmosis has been demonstrated in immunocompromised individuals in the past without retroperitoneal fibrosis. Our patient may have had chronic histoplasma infection of his retroperitoneal lymph nodes, triggering fibrosis in the area surrounding the adjacent celiac artery and abdominal aorta, thus leading to symptomatic MALS.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n Histoplasma capsulatum, an organism that has demonstrated its capability to cause fibrosis elsewhere in the body, may play a causative role in MALS in our patient, given the finding of retroperitoneal fibrosis in conjunction with retroperitoneal lymph node histoplasma.<\/jats:p>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2014.04.012","type":"journal-article","created":{"date-parts":[[2014,6,6]],"date-time":"2014-06-06T13:15:13Z","timestamp":1402060513000},"page":"473-475","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Histoplasmosis as a possible cause of retroperitoneal fibrosis and median arcuate ligament syndrome"],"prefix":"10.1097","volume":"5","author":[{"given":"Nicki","family":"Niemann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyone F.","family":"Hochman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard S.P.","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-11-20260114","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1001\/archsurg.1971.01350110102016","article-title":"A clinicoanatomical study of the arcuate ligament of the diaphragm","volume":"103","author":"Lindner","year":"1971","journal-title":"Arch Surg"},{"key":"R2-11-20260114","doi-asserted-by":"crossref","first-page":"731","DOI":"10.2214\/ajr.95.3.731","article-title":"Compression of the celiac trunk and abdominal angina","volume":"95","author":"Dunbar","year":"1965","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"key":"R4-11-20260114","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.avsg.2008.02.007","article-title":"Celiac revascularization as a requisite for treating the median arcuate ligament syndrome","volume":"22","author":"Wang","year":"2008","journal-title":"Ann Vasc Surg"},{"key":"R5-11-20260114","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1016\/j.jvs.2010.05.083","article-title":"Laparoscopic versus open celiac ganglionectomy in patients with median arcuate ligament syndrome","volume":"52","author":"Tulloch","year":"2010","journal-title":"J Vasc Surg"},{"key":"R6-11-20260114","first-page":"929","article-title":"State of the art: histoplasmosis","volume":"117","author":"Goodwin","year":"1978","journal-title":"Am Rev Respir Dis"},{"key":"R7-11-20260114","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1590\/S1806-37132009001100013","article-title":"Chapter 4 \u2014 histoplasmosis","volume":"35","author":"Aide","year":"2009","journal-title":"Jornal brasileiro de pneumologia"},{"key":"R8-11-20260114","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.diagmicrobio.2006.01.015","article-title":"Gastrointestinal histoplasmosis in the acquired immunodeficiency syndrome: report of 18 cases and literature review","volume":"55","author":"Assi","year":"2006","journal-title":"Diagn Microbiol Infect Dis"},{"key":"R9-11-20260114","first-page":"679","article-title":"Intestinal histoplasmosis in AIDS patients: report of three cases observed in France and review of the literature","volume":"7","author":"Trylesinski","year":"1995","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"R10-11-20260114","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1001\/archsurg.1993.01420160106018","article-title":"Intestinal perforation from gastrointestinal histoplasmosis in acquired immunodeficiency syndrome. 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