Buğra Tolga KONDUK, Murat Taner GÜLŞEN, Abdullah Emre YILDIRIM, Ayhan BALKAN, Samet ALKAN, Ramazan Erdem ER

KRONİK KARIN KAĞRISININ NADİR BİR NEDENİ: MEDİAN ARKUAT LİGAMENT SENDROMU

Median arkuat ligament sendromu, median arkuat ligamentin çölyak arter köküne basısı sonucu oluşur. Çölyak arter kökünde basıya sekonder gelişen darlık gastrointestinal sistem kan akımında azalmaya neden olur. Sendrom kendini genelikle postprandial ağrı ile belli eder ve özelikle ekspiryumda daha belirgin ağrı oluşur. Burada kronik karın ağısı ile tetkik edilip median arkuat ligament sendromu tanısı konulan ve cerrahi tedaviyle düzelme sağlanmayıp çölyak arter stentleme ile tamamen asemptomatik hale gelen genç bir erkek hasta sunulacaktır.

A Rare Cause of Chronic Abdominal Pain: Median Arcuate Ligament Syndrome

Median arcuate ligament syndrome occurs when median arcuate ligament pressures the root of the celiac artery. The root secondry to compression of the celiac artery stenosis causes decreased blood flow to the gastrointestinal tract. Generally it reveals itself with the post-prandial pain and pain increases with expirium. We present a young male patient with median arcuate ligament syndrome whom no improvement is achieved with surgical treatment and recovered with celiac artery stenting.

PDF

___

1. Aschenbach R, Basche S, Vogl TJ. Compression of the celiac trunk caused by median arcuate ligament in children and adolescent subjects: evaluation with contrast-enhanced MR angiography and comparison with Doppler US evaluation. J Vasc Interv Radiol 2011;22:556-61.
2. Desmond CP, Roberts SK. Exercise-related abdominal pain as a manifestation of the median arcuate ligament syndrome. Scand J Gastroenterol 2004;39:1310-3.
3. Park CM, et all. Celiac Axis Stenosis: Incidence and Etiologies in Asymptomatic Individuals Korean Journal of Radiology; 2001 March; 2: 8-13
4. Horton K M, Talamini M A, Fishman E K. Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics. 2005; 25(5):1177-82.
5. Oktay Ö, Memiş A, Parıldar M, Oran İ. Coeliac artery compression syndrome. Akademik Gastroentroloji Dergisi, 2003; 2 (3): 142-145.
6. Hongsakul K, Rookkapan S. Sungsiri J, Tubtawee T. A severe case of median arcuate ligament syndrome with successful angioplasty and stenting. Case Rep Vasc Med. 2012;2012:129870.
7. Grotemeyer D, Duran M, Iskandar F, Blondin D, Nguyen K, Sandmann W. Median arcuate ligament syndrome: vascular surgical therapy and follow-up of 18 patients, Langenbecks Arch Surg, 2009; 394: 1085-92.