Unusual Cause and Treatment of Uncontrolled Hypertension
Abstract
Median arcuate ligament syndrome (MALS) is a rare benign condition typically affecting young females. It usually presents with chronic abdominal pain, nausea, vomiting and weight loss. They are usually diagnosed incidentally on MDCT angiography. We report a rare adult male of MALS which presented with a recurrent hypertensive urgency without any abdominal pain leading to an extensive workup and incidental diagnosis of MALS which was successfully treated by angioplasty with stenting of celiac trunk without any complication.
[1] Harjola PT. A rare obstruction of the coeliac artery. Report of a case. Ann Chir Gynaecol Fenn. 1963;52:547-50.
[2] Göya C, Hamidi C, Hattapoğlu S, Çetinçakmak MG, Teke M, Kuday S. Diagnosis of median arcuate ligament syndrome on multidetector computed tomography. J Med Cases. 2013;4:616-9. https://doi.org/10.4021/jmc1384w
[3] Jimenez JC, Harlander-Locke M, Dutson EP. Open and lapa- roscopic treatment of median arcuate ligament syndrome. J Vasc Surg. 2012;56:869-73. https://doi.org/10.1016/j. jvs.2012.04.057
[4] Duffy AJ, Panait L, Eisenberg D, Bell RL, Roberts KE, Sumpio B. Management of median arcuate ligament syndrome: a new paradigm. Ann Vasc Surg. 2009;23:778-84. https://doi. org/10.1016/j.avsg.2008.11.005
[5] Hongsakul K, Rookkapan S, Sungsiri J, Tubtawee T. A severe case of median arcuate ligament syndrome with successful angio- plasty and stenting. Case Rep Vasc Med. 2012;2012:129870. https://doi.org/10.1155/2012/129870
[6] Horton KM, Talamini MA, Fishman EK. Median arcuate liga- ment syndrome: evaluation with CT angiography. Radiograph-ics. 2005;25:1177-82. https://doi.org/10.1148/rg.255055001
[7] Gander S, Mulder DJ, Jones S, Ricketts JD, Soboleski DA, Jus- tinich CJ. Recurrent abdominal pain and weight loss in an ad- olescent: celiac artery compression syndrome. Can J Gastro- enterol. 2010;24:91-3. https://doi.org/10.1155/2010/534654
[8] Chou SQH, Kwok KY, Wong LS, Fung DHS, Wong WK. Imaging features of median arcuate ligament syndrome. J Hong Kong Coll Radiol. 2010;13:101-3.
[9] Bobadilla JL. Mesenteric ischemia. Surg Clin North Am. 2013;93:925-40. https://doi.org/10.1016/j.suc.2013.04.002
[10] Eliahou R, Sosna J, Bloom AI. Between a rock and a hard place: Clinical and imaging features of vascular compression syndromes. RadioGraphics. 2012;31:E33-49. https://doi. org/10.1148/rg.321115011
[11] Sugae T, Fujii T, Kodera Y, Kanzaki A, Yamamura K, Yamada S, et al. Classification of the celiac axis stenosis owing to me- dian arcuate ligament compression, based on severity of the stenosis with subsequent proposals for management during pancreatoduodenectomy. Surgery. 2012;151:543-9. https:// doi.org/10.1016/j.surg.2011.08.012
[12] Dunbar JD, Molnar W, Beman FF, Marable SA. Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radi- um Ther Nucl Med. 1965;95:731-44. https://doi.org/10.2214/ ajr.95.3.731
[13] Cienfuegos JA, Rotellar F, Valentí V, et al. The celiac axis com- pression syndrome (CACS): critical review in the laparoscop- ic era. Rev Esp Enferm Dig. 2010;102:193-201. https://doi.org/10.4321/S1130-01082010000300006
[14] Silva JA, White CJ, Collins TJ, et al. Endovascular therapy for chronic mesenteric ischemia. J Am Coll Cardiol. 2006;47:944- 50. https://doi.org/10.1016/j.jacc.2005.10.056
[2] Göya C, Hamidi C, Hattapoğlu S, Çetinçakmak MG, Teke M, Kuday S. Diagnosis of median arcuate ligament syndrome on multidetector computed tomography. J Med Cases. 2013;4:616-9. https://doi.org/10.4021/jmc1384w
[3] Jimenez JC, Harlander-Locke M, Dutson EP. Open and lapa- roscopic treatment of median arcuate ligament syndrome. J Vasc Surg. 2012;56:869-73. https://doi.org/10.1016/j. jvs.2012.04.057
[4] Duffy AJ, Panait L, Eisenberg D, Bell RL, Roberts KE, Sumpio B. Management of median arcuate ligament syndrome: a new paradigm. Ann Vasc Surg. 2009;23:778-84. https://doi. org/10.1016/j.avsg.2008.11.005
[5] Hongsakul K, Rookkapan S, Sungsiri J, Tubtawee T. A severe case of median arcuate ligament syndrome with successful angio- plasty and stenting. Case Rep Vasc Med. 2012;2012:129870. https://doi.org/10.1155/2012/129870
[6] Horton KM, Talamini MA, Fishman EK. Median arcuate liga- ment syndrome: evaluation with CT angiography. Radiograph-ics. 2005;25:1177-82. https://doi.org/10.1148/rg.255055001
[7] Gander S, Mulder DJ, Jones S, Ricketts JD, Soboleski DA, Jus- tinich CJ. Recurrent abdominal pain and weight loss in an ad- olescent: celiac artery compression syndrome. Can J Gastro- enterol. 2010;24:91-3. https://doi.org/10.1155/2010/534654
[8] Chou SQH, Kwok KY, Wong LS, Fung DHS, Wong WK. Imaging features of median arcuate ligament syndrome. J Hong Kong Coll Radiol. 2010;13:101-3.
[9] Bobadilla JL. Mesenteric ischemia. Surg Clin North Am. 2013;93:925-40. https://doi.org/10.1016/j.suc.2013.04.002
[10] Eliahou R, Sosna J, Bloom AI. Between a rock and a hard place: Clinical and imaging features of vascular compression syndromes. RadioGraphics. 2012;31:E33-49. https://doi. org/10.1148/rg.321115011
[11] Sugae T, Fujii T, Kodera Y, Kanzaki A, Yamamura K, Yamada S, et al. Classification of the celiac axis stenosis owing to me- dian arcuate ligament compression, based on severity of the stenosis with subsequent proposals for management during pancreatoduodenectomy. Surgery. 2012;151:543-9. https:// doi.org/10.1016/j.surg.2011.08.012
[12] Dunbar JD, Molnar W, Beman FF, Marable SA. Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radi- um Ther Nucl Med. 1965;95:731-44. https://doi.org/10.2214/ ajr.95.3.731
[13] Cienfuegos JA, Rotellar F, Valentí V, et al. The celiac axis com- pression syndrome (CACS): critical review in the laparoscop- ic era. Rev Esp Enferm Dig. 2010;102:193-201. https://doi.org/10.4321/S1130-01082010000300006
[14] Silva JA, White CJ, Collins TJ, et al. Endovascular therapy for chronic mesenteric ischemia. J Am Coll Cardiol. 2006;47:944- 50. https://doi.org/10.1016/j.jacc.2005.10.056
| Files | ||
| Issue | Vol 8 No 3 (2023): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v8i3.14236 | |
| Keywords | ||
| Median arcuate ligaments syndrome Celiac artery stenosis Hypertensive urgency | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Elhout S, Habib M. Unusual Cause and Treatment of Uncontrolled Hypertension. CRCP. 2023;8(3):113-116.
