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, sa.12, 2015 (ESCI) identifier identifier

Özet

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.