A case of pancreatic cancer with concomitant median arcuate ligament syndrome treated successfully using an allograft arterial transposition

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Çelik S., Ringe K. I. , Boru C. E. , Constantinica V., Bektas H.

JOURNAL OF SURGICAL CASE REPORTS, no.12, 2015 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: Issue: 12
  • Publication Date: 2015
  • Doi Number: 10.1093/jscr/rjv161
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus
  • Van Yüzüncü Yıl University Affiliated: Yes


An association of pancreatic cancer and median arcuate ligament syndrome (MALS) is a rare and challenging situation in terms of treatment. A 60-year-old man diagnosed with pancreatic cancer underwent laparotomy. A pancreaticoduodenectomy was planned, but during the resection part of the operation, a celiac artery stenosis was noticed. The patient was diagnosed with MALS causing almost total celiac artery occlusion, with no radiological solution. The patient was re-operated the next day, and an iliac artery allograft was used for aorta-proper hepatic artery reconstruction, concomitant with the total pancreaticoduodenectomy. Preoperative meticulous evaluation of vascular structures of the celiac trunk and its branches is important, especially in pancreatic surgery. A vascular allograft may be a lifesaving alternative when vascular reconstruction is necessary.