Abstract
BACKGROUND: Median arcuate ligament release (MALR) surgery is the most common procedure used to treat median arcuate ligament syndrome (MALS). Estimates of the success rate of this surgery range from 70-80%. Factors that affect the success of this procedure are not well understood. CASE REPORT: Nine patients with abdominal pain and a vascular ultrasound study suggestive of MALS underwent a celiac plexus block. All 9 continued to surgery and experienced ≥ 50% pain reduction in the upper abdomen postoperatively. Eight of these 9 patients had a positive celiac plexus block. One of 9 patients with a negative prognostic block experienced ≥ 50% pain reduction in the upper abdomen after surgery. CONCLUSIONS: These data suggest that the accuracy of prognostic celiac plexus blocks in predicting successful MALR surgery is 89%. This can be compared to estimates of the success rate of surgery without prognostic blocks (70-80%). KEY WORDS: Chronic abdominal pain, median arcuate ligament release surgery, median arcuate ligament syndrome, nerve block prognostic value, upper abdomen
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