ArticleiGIE : innovation, investigation and insights2022
Safety and efficacy of EUS-guided celiac plexus block in the evaluation of patients with median arcuate ligament syndrome anatomy for possible surgery.
Article in iGIE : innovation, investigation and insights, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and aims: Median arcuate ligament syndrome (MALS) is often considered in the differential diagnosis of patients with intractable postprandial abdominal pain. However, the MALS anatomy with compression of the celiac artery can be seen in ≤13% to 50% of healthy individuals. Therefore, a symptomatic response to celiac plexus blockage can help identify patients who may respond to median arcuate ligament (MAL) release surgery. Celiac plexus blockade (CPB) can be done either by CT guidance through the back or by EUS guidance. Here, we describe the safety of, and outcomes in, 12 patients scheduled for EUS-guided CPB for possible MALS. Methods: This is a retrospective chart review of 12 patients (age range, 19-62 years) with postprandial abdominal pain and MAL anatomy who were scheduled for EUS-guided CPB for possible MALS. Results: EUS-guided CPB was successfully performed in 11 of 12 patients. One procedure was aborted owing to inability to visualize the celiac plexus. Of the patients who underwent EUS-guided CPB, 9 of 11 (82%) responded with improvement in symptoms, and no adverse events resulted from any EUS-guided CPB procedure. Eight of the 9 CPB responders underwent subsequent MAL release surgery. Conclusion: EUS-guided CPB is a safe approach to evaluating patients with MAL anatomy for possible surgery.
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