• J Coll Physicians Surg Pak · Feb 2022

    Case Reports

    Median Arcuate Ligament Compression on Celiac Trunk during Liver Transplantation Procedure.

    • Kaleem Ullah, Shams Uddin, and Abdul Wahab Dogar.
    • Department of Liver Transplantation, Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, Gambat, Sindh, Pakistan.
    • J Coll Physicians Surg Pak. 2022 Feb 1; 32 (2): 250-252.

    AbstractLow insertion of median arcuate ligament (MAL) can cause compression over the celiac trunk with subsequent complications. During liver transplantation procedure, the graft artery is usually anastomosed with the hepatic artery of the recipient, which arises from the celiac trunk. MAL compression might reduce hepatic arterial blood flow to the graft, which can induce postoperative hepatic arterial thrombosis, causing graft failure. Here, we report a case of liver transplant procedure, during which pulsation of hepatic artery of the recipient diminished dramatically, after ligation of gastro-duodenal artery. However, dissection and division of MAL restored excellent hepatic arterial blood flow. This case highlights the significance of prompt diagnosis and management of MAL compression syndrome in liver transplant recipients during transplant surgery. Key Words: Celiac trunk, Median arcuate ligament, Liver transplant.

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