Median Arcuate Ligament Syndrome With Concomitant Hyperkinetic Gallbladder

Area of Science:

• Gastroenterology
• Vascular Surgery
• Abdominal Imaging

Background:

• Median arcuate ligament syndrome (MALS) involves celiac artery compression, causing epigastric and postprandial pain.
• Hyperkinetic gallbladder dyskinesia (HGBD), characterized by a gallbladder ejection fraction (GBEF) over 80%, shares overlapping symptoms with MALS.
• Differentiating these conditions is crucial for effective patient management.

Purpose of the Study:

• To investigate the prevalence of HGBD in patients surgically treated for MALS.
• To evaluate the clinical presentation and surgical outcomes in patients with both HGBD and MALS.

Main Methods:

• Retrospective chart review of patients who underwent MALS surgery.
• Identification of patients with a history of HGBD based on GBEF measurements.
• Analysis of patient demographics, symptoms, comorbidities, and surgical outcomes.

Main Results:

• Six out of 69 patients (8.7%) undergoing MALS surgery also had HGBD (GBEF >80%).
• The cohort was predominantly female (83.3%) with a mean age of 31 years.
• All patients reported symptomatic improvement after MALS surgery, and most had multiple vascular compression syndromes.

Conclusions:

• Patients with HGBD should be evaluated for MALS due to overlapping symptoms.
• Surgical decompression for MALS is an effective treatment for patients with coexisting HGBD.
• Early diagnosis and surgical intervention can significantly improve quality of life.