Open repair and subsequent stenting to treat median arcuate ligament syndrome secondary to Roux-en-Y gastric bypass

开放性修复及后续支架置入术治疗Roux-en-Y胃旁路术后继发的正中弓状韧带综合征

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Abstract

Median arcuate ligament syndrome (MALS) is characterized by external compression of the celiac artery (CA) by the median arcuate ligament. There have been three reports of MALS following gastric bypass surgery, but this pathophysiology remains incompletely understood. We report a patient with MALS and a surgical history including Roux-en-Y gastric bypass. After workup, she was treated with open release of the median arcuate ligament and CA patch angioplasty, with subsequent CA artery stenting for recurrent stenosis. We will discuss potential mechanisms by which Roux-en-Y gastric bypass can lead to MALS and management strategies for it.

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