Acute Median Arcuate Ligament Syndrome Onset: Unexpected complication after laparoscopic Nissen fundoplication

Abstract

We present the case of a female patient who acutely developed median arcuate ligament syndrome with severe hepatic cytolysis, short after laparoscopic Nissen fundoplication for reflux esophagitis. CT angiography proposed the diagnosis of median arcuate ligament syndrome, causing severe hepatic, splenic and gastric ischaemia. Immediate surgery confirmed the diagnosis and division of the ligament was successfully accomplished, with subsequent organic reperfusion and no major complication on follow-up. To the best of our knowledge, the potential association between median arcuate ligament syndrome and Nissen fundoplication has not previously been documented in the literature.