Simultaneous laparoscopic treatment of median arcuate ligament syndrome and segmental adenomyomatosis of the gallbladder: A case report

Daigo Kuboki; Ayaki Koide; Satoshi Taguchi; Hironobu Yamazaki; Alan Kawarai Lefor; Takafumi Tabuchi

doi:10.1016/j.ijscr.2022.107869

Simultaneous laparoscopic treatment of median arcuate ligament syndrome and segmental adenomyomatosis of the gallbladder: A case report

Int J Surg Case Rep. 2023 Feb:103:107869. doi: 10.1016/j.ijscr.2022.107869. Epub 2023 Jan 2.

Authors

Daigo Kuboki¹, Ayaki Koide², Satoshi Taguchi², Hironobu Yamazaki³, Alan Kawarai Lefor⁴, Takafumi Tabuchi²

Affiliations

¹ Department of Surgery, Kitaibaraki City Hospital, 1050, Sekimotoshimo, Sekinami-cho, Kitaibaraki-shi, Ibaraki, Japan; Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, Japan. Electronic address: m05037dk@jichi.ac.jp.
² Department of Surgery, Kitaibaraki City Hospital, 1050, Sekimotoshimo, Sekinami-cho, Kitaibaraki-shi, Ibaraki, Japan.
³ Department of Surgery, Kitaibaraki City Hospital, 1050, Sekimotoshimo, Sekinami-cho, Kitaibaraki-shi, Ibaraki, Japan; Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, Japan.
⁴ Department of Surgery, Division of Gastroenterological, General and Transplant Surgery, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, Japan.

Abstract

Introduction: Median Arcuate Ligament Syndrome (MALS) is a condition in which the median arcuate ligament tightly compresses the celiac artery. A patient presented with MALS and segmental adenomyomatosis of the gallbladder, both treated simultaneously using a laparoscopic approach.

Presentation of case: A 48-year-old male with adenomyomatosis of the gallbladder presented with postprandial epigastric pain. Abdominal three-dimensional computed tomography scan showed compression of the celiac artery, and the patient was diagnosed with MALS. Laparoscopic dissection of the median arcuate ligament and cholecystectomy were performed to treat both conditions. By optimizing port positions, both conditions could be treated simultaneously. The patient was discharged on postoperative day 6 and has no recurrent symptoms 20 months postoperatively.

Discussion: To the best of our knowledge, there are no previously reported cases of simultaneous laparoscopic division of the median arcuate ligament and cholecystectomy.

Conclusion: By optimizing the port positions, laparoscopic division of the median arcuate ligament and cholecystectomy were performed simultaneously, minimally invasively, safely and effectively.

Keywords: Adenomyomatosis of the gallbladder; Case report; Cholecystectomy; Functional dyspepsia; Laparoscopic surgery; Median arcuate ligament syndrome.

Publication types

Case Reports