{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:52:09Z","timestamp":1789555929396,"version":"build-2803163510"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction:<\/jats:title>\n Median arcuate ligament syndrome (MALS) is a rare condition caused by the compression of the celiac trunk by the median arcuate ligament, which may trigger a typical symptom triad: postprandial abdominal pain, weight loss, nausea and vomiting.<\/jats:p>\n <\/jats:sec>\n \n Clinical case:<\/jats:title>\n A 58-year-old male was admitted to the emergency department due to abdominal pain, vomiting, fever and diarrhea. On admission, the patient was tachycardic, had abdominal distension, no peritoneal irritation signs, and a serum lactate level of 5 mmol\/L. The computed tomography (CT) scan showed gastric and intestinal pneumatosis associated with pneumoportia. Conservative treatment with intravenous fluids, antibiotics and low molecular weight heparin, was initiated. The reassessment CT scan showed resolution of the gastric and intestinal pneumatosis and a severe stenosis of the initial portion of the celiac trunk with associated angulation. After recovery from the acute episode, an abdominal duplex ultrasound and an aortoiliac arteriography in forced inspiration and expiration was performed, corroborating the diagnosis of MALS. A laparoscopic decompression of the celiac trunk was performed.<\/jats:p>\n <\/jats:sec>\n \n Discussion:<\/jats:title>\n Symptoms of MALS closely mimic other abdominal disorders, and it should be considered in the differential diagnosis. Currently, there are no international guidelines on MALS diagnostic criteria. Treatment is focused on decompression of the median arcuate ligament constriction of the celiac artery, with or without celiac lymph node removal.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n MALS diagnostic and therapeutic approach must be patient focused. Laparoscopic decompression is an effective treatment and can provide immediate symptomatic relief, associated with the benefits of the less invasive nature of the procedure.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.106686","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T11:42:01Z","timestamp":1640000521000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Median arcuate ligament syndrome"],"prefix":"10.1097","volume":"90","author":[{"given":"Joana Isabel","family":"Almeida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida Nunes","family":"Coelho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Armas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Soares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-42-20260310","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.1308\/rcsann.2015.0025","article-title":"Laparoscopic decompression as treatment for median arcuate ligament syndrome","volume":"97","author":"Rubinkiewicz","year":"2015","journal-title":"Ann. R. Coll. Surg. Engl"},{"key":"R3-42-20260310","doi-asserted-by":"crossref","first-page":"74","DOI":"10.2298\/SARH1502074K","article-title":"Surgical treatment of median arcuate ligament syndrome: case report and review of literature","volume":"143","author":"Kotara\u0107","year":"2015","journal-title":"Srp. Arh. Celok. Lek"},{"key":"R4-42-20260310","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1016\/j.jvs.2019.11.012","article-title":"Median arcuate ligament syndrome","volume":"71","author":"Goodall","year":"2020","journal-title":"J. Vasc. Surg"},{"key":"R5-42-20260310","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jvs.2008.11.124","article-title":"Celiac artery compression syndrome managed by laparoscopy","volume":"50","author":"Baccari","year":"2009","journal-title":"J. Vasc. 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Surg"},{"key":"R7-42-20260310","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1001\/jamasurg.2016.0002","article-title":"Median arcuate ligament syndrome-review of this rare disease","volume":"151","author":"Kim","year":"2016","journal-title":"JAMA Surg"},{"key":"R8-42-20260310","doi-asserted-by":"crossref","first-page":"108","DOI":"10.5582\/irdr.2019.01031","article-title":"Laparoscopic treatment of median arcuate ligament syndrome","volume":"8","author":"Sun","year":"2019","journal-title":"Intractable Rare Dis Res"},{"key":"R9-42-20260310","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1007\/s11936-008-0012-2","article-title":"Median arcuate ligament syndrome","volume":"10","author":"Duncan","year":"2008","journal-title":"Curr. Treat. Options Cardiovasc. Med"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261221011883?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261221011883?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2021.106686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:01:14Z","timestamp":1773136874000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2021.106686"}},"subtitle":["A case report of a rare disease"],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":8,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2021.106686","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}