med arcuate lig syndrome1
TRANSCRIPT
Median Arcuate Ligament Syndromedr walid agmy
61 years old man with epigastric pain and vomiting
The median arcuate ligament is a fibrous arch unites the diaphragmatic crura .
in some people, the ligament inserts low or celiac art originate high.
young patients (20–40 y), F : M
CT angiograms: focal narrowing in the proximal celiac axis. inspiration and expiration 2ry signs poststenotic dilatation and collaterals.
ttt : surgery.
angulations and narrowing of the proximal celiac axis.
Sagittal 3D image of a patient with epigastric pain
Sagittal (MIP) of a patient with recurrent abdominal pain reveals focal calcified plaque.
Prostglandin induced hyperostosisdr walid agmy
Caffey disease(ICH)• AD .• subperiosteal bone formation• before 6 months, M:f 1:1• General hyperirritability, fever and anorexia,
painful, firm soft-tissue swelling.
PGE• TTT infants with cyanotic heart disease • cortical hyperostosis that mimics ICH.• PGE serum levels elevated • Indomethacin.
•
DD
- Physiological in infant not more than 4 m.
- trauma.
- Hypervitaminosis A.
- scurvy
- prostaglandin E1 and E2 administration , 42% of infants for more than 30 days; this increases to 100% in more than 60 days.8
- infection (including syphilis)
- metastatic neuroblastoma.
Thank you