A Role for Vascular Surgery in a Curious Case of Abdominal P
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Ms. A is a 28-year-old woman who had upper abdominal pain of 18 months’ duration and an associated 70-pound weight loss. The pain was intense and triggered by eating.

She underwent an extensive gastroenterology workup -including esophagogastroduodenoscopy, endoscopic ultrasound, capsule enteroscopy, hepatobiliary iminodiacetic acid (HIDA) scan, CT and MRI - which suggested compression of her celiac axis by her median arcuate ligament. Vascular ultrasound confirmed this and showed velocities in the celiac axis of 450 cm/sec without inspiration and 215 cm/sec with inspiration. Flows were normal in the superior mesenteric artery.

Vascular surgery and general surgery consultation confirmed that she would benefit from laparoscopic release of the median arcuate ligament. Surgery was performed by the combined team, and a full release of the ligament (Figures 1 and 2) and lysis of the celiac plexus were performed. She recovered well and was discharged on postoperative day 2, tolerating a regular diet without pain for the first time in over a year.....

https://consultqd.clevelandclinic.org/2014/07/case-study-a-role-for-vascular-surgery-in-a-curious-case-of-abdominal-pain-and-major-weight-loss/
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