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Simultaneous Compression of the Celiac Trunk, Superior Mesenteric Artery, and Renal Arteries by the Median Arcuate Ligament: About One Case
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作者 Siddick Oumar Kenza Fathallah +5 位作者 Hassan Ahmed Aicha Merzem Hasnaa Belgadir Omar Amriss Nadia Moussali Naima El Benna 《Open Journal of Medical Imaging》 2024年第3期106-113,共8页
Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insert... Median arcuate ligament syndrome (MALS), is a rare abdominal vascular compression syndrome caused by the compression of the proximal celiac trunk by the median arcuate ligament. According to many authors, a low insertion of the diaphragmatic crura or an abnormally high origin of the celiac trunk from the aorta can cause compression of the celiac artery. Usually, patients with MALS are asymptomatic. Computed tomography (CT) angiography of the abdomen is the main imaging modality to confirm the diagnosis. The coexistence of celiac trunk and superior mesenteric artery compression by the median arcuate ligament is rarely described in the literature. To our knowledge, until now, a simultaneous combination of three abdominal vascular compressions by the median arcuate ligament has never been described. From this case, we report a simultaneous compression of the celiac trunk, superior mesenteric artery, and renal arteries by the median arcuate ligament. 展开更多
关键词 median arcuate ligament syndrome (mals) Celiac Trunk Compression Superior Mesenteric Artery and Renal Arteries Compression Computed Tomography Angiography
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Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience 被引量:1
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作者 Alexandros Giakoustidis Stavros Moschonas +6 位作者 Gregory Christodoulidis Danae Chourmouzi Anna Diamantidou Sophia Masoura Eleni Louri Vasileios N Papadopoulos Dimitrios Giakoustidis 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第6期1048-1055,共8页
The median arcuate ligament syndrome(MALS)is recognized as a rare clinical entity,characterized by chronic post-prandial abdominal pain,nausea,vomiting,and unintentional weight loss.Due to its vague symptomatology,it ... The median arcuate ligament syndrome(MALS)is recognized as a rare clinical entity,characterized by chronic post-prandial abdominal pain,nausea,vomiting,and unintentional weight loss.Due to its vague symptomatology,it is mainly regarded as a diagnosis of exclusion.Patients can often be misdiagnosed for several years before a correct diagnosis is established,also due to a medical team’s clinical suspicion.We present a case series of two patients who suffered from MALS and were treated successfully.The first patient is a 32-year-old woman,presenting with post-prandial abdominal pain and weight loss that have lasted for the past ten years.The second patient,a 50-year-old woman,presented with similar symptomatology,with the symptoms lasting for the last five years.Both cases were treated by laparoscopic division of the median arcuate ligament fibers,which alleviated extrinsic pressure from the celiac artery.Previous cases of MALS were retrieved from PubMed,to assemble a better diagnostic algorithm and propose a treatment method of choice.The literature review suggests an angiography with a respiratory variation protocol as the diagnostic modality of choice,along with the laparoscopic division of the median arcuate ligament fibers as the proposed treatment of choice. 展开更多
关键词 median arcuate ligament syndrome Dunbar syndrome Celiac trunk compression syndrome Celiac artery compression syndrome Case series Review
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Median arcuate ligament syndrome with retroperitoneal haemorrhage:A case report
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作者 Xiao-Chen Lu Jian-Guo Pei +2 位作者 Guang-Hua Xie Yong-Yu Li Hong-Mei Han 《World Journal of Clinical Cases》 SCIE 2022年第21期7509-7516,共8页
BACKGROUND Median arcuate ligament syndrome(MALS)is relatively rare and is due to extraluminal compression of the coeliac artery by the median arcuate ligament of the diaphragm.Here,we report a case of MALS found in a... BACKGROUND Median arcuate ligament syndrome(MALS)is relatively rare and is due to extraluminal compression of the coeliac artery by the median arcuate ligament of the diaphragm.Here,we report a case of MALS found in a patient with abdominal pain and retroperitoneal haemorrhage for education and dissemination.CASE SUMMARY This article describes a 46-year-old female patient who was admitted to our hospital with abdominal pain as her chief complaint.She had experienced no obvious symptoms but had retroperitoneal bleeding during the course of the disease.Contrast-enhanced computed tomography(CT)and noninvasive CT angiography(CTA)led to an initial misdiagnosis of pancreaticoduodenal artery aneurysm(PDAA)causing retroperitoneal hemorrhage.After intraoperative exploration and detailed analysis of enhanced CT and CTA images,a final diagnosis of MALS was made.The cause of the haemorrhage was bleeding from a branch of the gastroduodenal artery,not rupture of a PDAA.The prognosis of MALS combined with PDAA treated by laparoscopy and interventional therapy is still acceptable.The patient was temporarily treated by gastroduodenal suture haemostasis and was referred for further treatment.CONCLUSION MALS is very rare and usually has postprandial abdominal pain,upper abdominal murmur,and weight loss.It is diagnosed by imaging or due to complications.When a patient has abdominal bleeding or PDAA,we should consider whether the patient has celiac trunk stenosis(MALS or other etiology).When abdominal bleeding is combined with an aneurysm,we generally think of aneurysm rupture and hemorrhage first,but it may also be collateral artery rupture and hemorrhage. 展开更多
关键词 median arcuate ligament syndrome Retroperitoneal haemorrhage Pancreaticoduodenal artery aneurysm Case report
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Feasible management of median arcuate ligament syndrome in orthotopic liver transplantation recipients
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作者 Shu-Xuan Li Ye-Hui Fan +1 位作者 Guang-Yao Tian Guo-Yue Lv 《World Journal of Gastrointestinal Surgery》 SCIE 2022年第9期976-985,共10页
BACKGROUND In orthotopic liver transplantation(OLT)recipients,median arcuate ligament syndrome(MALS)is considered a risk factor for hepatic arterial thrombosis(HAT),which is dreadful for OLT recipients.Different alter... BACKGROUND In orthotopic liver transplantation(OLT)recipients,median arcuate ligament syndrome(MALS)is considered a risk factor for hepatic arterial thrombosis(HAT),which is dreadful for OLT recipients.Different alternative surgical procedures have been proposed to overcome the impact of MALS on transplantation,but clinical evidence is still scarce.AIM To evaluate the feasible surgical management of MALS to reduce complications in OLT patients.METHODS Data for 288 consecutive patients who underwent OLT at The First Hospital of Jilin University between January 2017 and July 2020 were retrospectively reviewed.The surgical management of median arcuate ligament(MAL)and modifications to the arterial anastomosis were recorded.The perioperative and long-term prognosis of MALS recipients were noted.Detailed preoperative and postoperative data of patients were analyzed in a descriptive manner.RESULTS Eight patients with MALS were included in this study.The first patient with MALS received no intervention during the primary surgery and developed postoperative HAT.Salvage liver transplantation with MAL division was successfully performed.Gastroduodenal artery(GDA)preservation with splenic artery ligation was performed on three patients,only GDA preservation was performed on two patients,and no intervention was performed on two patients.No patient developed HAT after surgery and postoperative recovery was satisfactory.CONCLUSION The preservation of collateral circulation between the superior mesenteric artery and celiac trunk via the GDA with or without splenic artery ligation is a safe and feasible alternative to MAL division. 展开更多
关键词 Orthotopic liver transplantation median arcuate ligament syndrome Surgical complications Surgical management Hepatic artery thrombosis
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Median arcuate ligament syndrome complicated with gallbladder stones:A case report
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作者 Jun-Qiang Dang Qing-Qiang Wang +3 位作者 Yan-Ling Yang Lin Shang Qi-Tian Bian Hong-Jun Xiang 《World Journal of Clinical Cases》 SCIE 2023年第32期7881-7887,共7页
BACKGROUND Median arcuate ligament syndrome(MALS)is a rare disease caused by compression of the celiac trunk artery by the median arcuate ligament(MAL).It can cause symptoms of postprandial abdominal pain,weight loss,... BACKGROUND Median arcuate ligament syndrome(MALS)is a rare disease caused by compression of the celiac trunk artery by the median arcuate ligament(MAL).It can cause symptoms of postprandial abdominal pain,weight loss,and nausea and vomiting.CASE SUMMARY A 55-year-old woman was admitted due to abdominal pain,nausea and vomiting.On admission,the patient presented with epigastric pain that worsened after eating,without signs of peritoneal irritation.Computed tomography angiography of the upper abdomen showed compression of the proximal segment of the abdominal trunk,local luminal stenosis with angular“fishhook”changes,which changed significantly during forceful inspiration and expiration;gallbladder stones;and multiple cysts in the liver.Abdominal duplex ultrasonography showed that peak systolic velocity was 352 cm/s.After diagnosis of MALS was confirmed,an arch ligament release procedure was performed.MALS has no specific symptoms and can be misdiagnosed as other abdominal diseases.Awareness of MALS should be improved to avoid misdiagnosis.The commonly used treatment option is MAL release and resection of the peripheral ganglion of the celiac trunk artery.CONCLUSION The diagnosis and treatment of MALS must be individualized,and MAL release is effective and provides immediate symptomatic relief. 展开更多
关键词 median arcuate ligament syndrome Celiac artery compression syndrome Operative decompression Case report
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机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征6例
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作者 马于祺 马云涛 +4 位作者 马雕龙 杨婧 詹渭鹏 蔡辉 狐鸣 《中国微创外科杂志》 CSCD 北大核心 2024年第10期678-682,共5页
目的探讨机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征(median arcuate ligament syndrome,MALS)的可行性。方法2019年6月~2023年10月我们采用机器人辅助下“3+1”手术模式治疗6例MALS。采用机器人辅助“3+1”手术模式(3个机械臂... 目的探讨机器人辅助下“3+1”手术模式治疗正中弓状韧带综合征(median arcuate ligament syndrome,MALS)的可行性。方法2019年6月~2023年10月我们采用机器人辅助下“3+1”手术模式治疗6例MALS。采用机器人辅助“3+1”手术模式(3个机械臂和1个助手孔的四孔操作方法),通过腹腔干血管游离方式,经脾动脉后方入路,解除正中弓状韧带对腹腔干的压迫。结果6例均成功完成机器人辅助下“3+1”模式手术。手术操作时间(包括接机和撤机的时间)38~52 min,平均43.2 min;术中出血量5~25 ml,平均15 ml。术后住院时间6~9 d,平均7.5 d。6例术后随访1~45个月(中位随访时间2.5月),1例体重未变,5例体重增加1.0~2.0 kg,平均1.5 kg;5例餐后上腹痛症状完全消失,1例症状减轻但未完全缓解。结论机器人辅助下“3+1”手术模式经脾动脉后方入路腹腔干血管游离方式治疗MALS安全可行。 展开更多
关键词 正中弓状韧带综合征 机器人手术
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基于腹部CTA腹腔干正中弓状韧带压迫的影像解剖学研究
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作者 李晶晶 龚沈初 尹剑兵 《中国临床解剖学杂志》 CSCD 北大核心 2024年第4期424-428,434,共6页
目的回顾性研究正中弓状韧带(median arcuate ligament,MAL)引起腹腔干(celiacartery,CA)压迫的流行病学、解剖学特征。方法测量MAL和CA起始位置及两者距离;CA受压程度,腹腔干主动脉角(angleofemergence,AE)及腹腔干折角(foldangle,FA)... 目的回顾性研究正中弓状韧带(median arcuate ligament,MAL)引起腹腔干(celiacartery,CA)压迫的流行病学、解剖学特征。方法测量MAL和CA起始位置及两者距离;CA受压程度,腹腔干主动脉角(angleofemergence,AE)及腹腔干折角(foldangle,FA)。分析MAL引起CA压迫的解剖学特征与基线特征。结果MAL和CA椎体起始水平与BMI呈负相关。MAL/CA重叠组与非重叠组在BMI、MAL、CA椎体起始位置等方面的差异有统计学意义。AE、FA与BMI相关。MAL引起CA压迫占9.7%,其中符合正中弓状韧带综合征(median arcuate ligament syndrome,MALS)占4.6%。BMI、AE、FA的差异在腹腔干压迫组与非压迫组间有统计学意义。结论本研究为MALS的解剖学、病理学及临床诊治研究提供依据。 展开更多
关键词 正中弓状韧带综合征 腹腔干压迫 腹部CTA 影像解剖
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正中弓状韧带压迫综合征伴中结肠动脉瘤破裂致腹膜后血肿1例
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作者 陈观木 王贤明 +1 位作者 华先平 郑国良 《中国医学影像技术》 CSCD 北大核心 2024年第9期1455-1455,共1页
患者男,54岁,突发左中腹痛1天;间断腹痛10年,经多次胃镜及腹部超声、CT检查均未见明显异常;高血压史20年,无腹部手术、外伤史。查体:左中腹压痛(+),可疑移动性浊音。实验室检查:血红蛋白100 g/L。
关键词 正中弓状韧带压迫综合征 动脉瘤破裂 超声检查 体层摄影术 X线计算机
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腹腔动脉狭窄的介入治疗 被引量:1
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作者 王茂强 王志军 +1 位作者 刘凤永 王仲朴 《介入放射学杂志》 CSCD 2005年第1期27-30,共4页
目的 报道用介入方法治疗 2例腹腔动脉 (CA)狭窄的疗效。方法  2例患者有长期进餐后腹痛、伴有体重下降和上腹部血管杂音 ,Doppler超声提示CA狭窄 ,经腹主动脉造影证实。 1例CA狭窄为典型膈肌中脚综合征 (MALS) ,另 1例狭窄为动脉粥... 目的 报道用介入方法治疗 2例腹腔动脉 (CA)狭窄的疗效。方法  2例患者有长期进餐后腹痛、伴有体重下降和上腹部血管杂音 ,Doppler超声提示CA狭窄 ,经腹主动脉造影证实。 1例CA狭窄为典型膈肌中脚综合征 (MALS) ,另 1例狭窄为动脉粥样硬化所致。介入技术包括常规经皮经腔血管成型 (PTA)和支架置入术。结果 腹主动脉造影显示 2例均为重度CA狭窄 ,狭窄程度大于 90 %。术中做PTA和支架置入 ,1例用球囊扩张式Palmaz支架、1例用Wallstents ,术后造影显示CA血流通畅。Doppler超声随访提示CA血流速度正常。术后 3个月随访 ,患者症状消失、体重增加 ;分别随访 16、2 6个月 ,无再狭窄证据。结论 PTA和支架置入是治疗CA狭窄的安全。 展开更多
关键词 狭窄 CA 腹腔动脉 介入治疗 随访 支架置入 腹主动脉造影 患者 血管 超声
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中弓韧带压迫综合征外科手术治疗进展 被引量:4
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作者 于砚滢 王晶晶 +6 位作者 来志超 李康 徐乐吟 方荔菁 马江宇 于小晰 刘暴 《中国医学科学院学报》 CAS CSCD 北大核心 2021年第2期283-287,共5页
中弓韧带压迫综合征为正中弓状韧带压迫腹腔干动脉导致的一种罕见疾病。对于症状严重且影像学检查明确的患者,必须采用手术治疗。正中弓状韧带松解术是手术治疗的基石。多数情况下,术后即刻可恢复腹腔干的血运。可选方式有开放式手术、... 中弓韧带压迫综合征为正中弓状韧带压迫腹腔干动脉导致的一种罕见疾病。对于症状严重且影像学检查明确的患者,必须采用手术治疗。正中弓状韧带松解术是手术治疗的基石。多数情况下,术后即刻可恢复腹腔干的血运。可选方式有开放式手术、腹腔镜手术或者机器人协助手术。其中,腹腔镜手术因其创伤小、恢复快的优势而成为首选方案。同时,辅助腹腔神经丛切除术可减少患者的不适感。若术后腹腔干动脉持续狭窄,可进一步行血运重建术,如腔内治疗或动脉搭桥手术。腔内治疗创伤更小,而动脉搭桥手术的再狭窄率更低。本文将梳理总结中弓韧带压迫综合征的外科治疗的共识以及最新进展,希望有助于为本病的外科治疗提供思路。 展开更多
关键词 中弓韧带压迫综合征 中弓韧带松解术 血管重建术 腔内治疗
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正中弓状韧带综合征合并胰十二指肠动脉瘤1例 被引量:1
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作者 高文峰 张碧辉 +1 位作者 牛国晨 杨敏 《中国介入影像与治疗学》 CSCD 北大核心 2018年第2期122-122,共1页
患者女,32岁,因“体检B超发现腹腔动脉瘤”就诊。患者无腹痛等症状,体格检查及实验室检查均未见异常。
关键词 正中弓状韧带综合征 胰十二指肠动脉瘤 栓塞 治疗性
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超声测量6~12岁儿童呼吸末腹腔干与主动脉夹角及腹腔干血流峰值
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作者 王玉莹 韦德湛 +1 位作者 宁浩杰 谢宏基 《佛山科学技术学院学报(自然科学版)》 CAS 2020年第1期20-24,共5页
目的通过超声测量无中弓韧带压迫综合症症状6~12岁儿童呼、吸末腹腔干与主动脉夹角及血流峰值,并评估其正常范围。方法通过超声检查测量600例(男女各300例)无MALS症状6~12岁儿童,观察腹腔干起始段走行,再分别测量腹腔干与主动脉夹角及... 目的通过超声测量无中弓韧带压迫综合症症状6~12岁儿童呼、吸末腹腔干与主动脉夹角及血流峰值,并评估其正常范围。方法通过超声检查测量600例(男女各300例)无MALS症状6~12岁儿童,观察腹腔干起始段走行,再分别测量腹腔干与主动脉夹角及吸气末、呼气末腹腔干收缩期峰值速度,计算呼气末与吸气末血流速度变化率。结果6~12岁儿童吸气末腹腔干与主动脉角平均为(51.8±15.6)°(95%可信区间48.4~55.2°),收缩期血流峰值速度为(97.7±14.2)cm/s(95%可信区间94.6~100.8 cm/s);呼气末腹腔干与主动脉角平均为(75.1±20.3)°(95%可信区间69.7~80.4°),收缩期血流峰值速度为(106.4±18.2)cm/s(95%可信区间102.4~110.8 cm/s)。吸气末与呼气末腹腔干血流速度变化率为(10.63±7.75)%。结论通过超声测量正常6~12岁儿童呼、吸末腹腔干与主动脉夹角,腹腔干收缩期血流峰值速度及其变化率的正常值范围有助于通过超声诊断6~12岁儿童中弓韧带压迫综合征。 展开更多
关键词 儿童 腹腔干 中弓韧带压迫综合征 超声检查 多普勒
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正中弓状韧带综合征1例 被引量:1
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作者 余广海 袁玉山 王欣 《罕少疾病杂志》 2021年第5期3-3,37,共2页
正中弓状韧带综合征(MALS)是临床上相对少见的一种综合征,该疾病容易与肝胆胰及胃肠道疾病混淆。本文就1例正中弓状韧带综合征的临床及影像资料进行回顾性总结。
关键词 正中弓状 韧带综合征
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1例正中弓状韧带压迫综合征患者的围手术期护理
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作者 朱慧娣 章梅云 +2 位作者 严莉莉 江月红 徐巧英 《中华护理杂志》 CSCD 北大核心 2024年第15期1891-1895,共5页
总结1例正中弓状韧带压迫综合征患者的围手术期护理经验。护理要点:缓解局部受压程度,改善胃肠道症状;建立以腹痛为主线的监测评估方案,谨防严重血管不良事件发生;实施预康复护理,降低手术风险;积极做好术后胃瘫综合征的护理及出院后延... 总结1例正中弓状韧带压迫综合征患者的围手术期护理经验。护理要点:缓解局部受压程度,改善胃肠道症状;建立以腹痛为主线的监测评估方案,谨防严重血管不良事件发生;实施预康复护理,降低手术风险;积极做好术后胃瘫综合征的护理及出院后延续护理。患者于术后第22天出院,随访6个月,体重有所增加,生活质量提高。 展开更多
关键词 正中弓状韧带压迫综合征 慢性腹痛 围手术期护理
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正中弓状韧带压迫综合征双源CT血管造影表现 被引量:4
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作者 曹阿丹 宋敏 +5 位作者 武乐乐 杨浩 胡舸帆 郑丽远 李小琼 郭海燕 《临床放射学杂志》 北大核心 2021年第6期1235-1238,共4页
目的评价双源CT血管成像(DSCTA)对正中弓韧带压迫综合征的诊断价值。方法对14例正中弓韧带压迫综合征行动脉期三维重建,结合横断面、容积重建、多平面重组及最大密度投影观察腹腔干外压性狭窄情况、腹腔内脏动脉瘤及侧支血管情况。结果1... 目的评价双源CT血管成像(DSCTA)对正中弓韧带压迫综合征的诊断价值。方法对14例正中弓韧带压迫综合征行动脉期三维重建,结合横断面、容积重建、多平面重组及最大密度投影观察腹腔干外压性狭窄情况、腹腔内脏动脉瘤及侧支血管情况。结果14例患者CTA均表现为腹腔干起始段外压性狭窄,腹腔干狭窄率40%~90%。其中轻度狭窄9例,表现为"V"型凹陷结构,狭窄远端无扩张或轻度扩张,无侧支循环形成;重度狭窄5例,表现为典型"钩状"狭窄、侧支血管及腹腔内脏动脉瘤。结论DSCTA能够准确诊断和评价正中弓状韧带压迫性腹腔干狭窄及其伴发的侧支循环或腹腔内脏动脉瘤,具有重要的临床应用价值。 展开更多
关键词 双源CT 血管造影术 计算机体层摄影术 腹腔动脉受压 正中弓状韧带压迫综合征
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腹腔镜手术治疗正中弓状韧带综合征2例报告 被引量:1
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作者 李宇 刘学民 +1 位作者 白纪刚 吕毅 《中国实用外科杂志》 CAS CSCD 北大核心 2022年第2期238-240,共3页
正中弓状韧带(median arcuate ligament,MAL)是连接两侧膈肌纤维脚的纤维韧带,构成主动脉裂孔的前缘。通常MAL位于腹腔干上方,约10%~24%病人该韧带可位于腹腔干前上方,少数情况下压迫动脉或神经可引起腹痛等临床症状。
关键词 正中弓状韧带综合征 腹腔镜
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