Annals of vascular surgery · 2026
Pediatric Abdominal Vascular Compression Syndromes: Clinical Presentation, Comorbidities, and Outcomes Following Surgical Correction.
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Mahan David S, Brandeis Benjamin, Nagarsheth Khanjan H
Аннотация
OBJECTIVES: The goal of this case series was to characterize the clinical presentation, comorbidities, and postoperative outcomes of pediatric patients who underwent surgical repair for Median Arcuate Ligament Syndrome (MALS) and/or Nutcracker Syndrome (NCS).
METHODS: We conducted a retrospective chart review of 17 pediatric patients who underwent open surgical repair for MALS and/or NCS at a single academic center from 2021-2025.
RESULTS: The most common comorbidities included postural orthostatic tachycardia syndrome (POTS), hypermobile Ehlers-Danlos syndrome (hEDS), gallbladder pathology, and additional vascular compressions. All 17 patients presented with abdominal pain, and more than half reported postprandial pain and/or nausea. Open surgical repair provided patient-reported symptomatic improvement in all patients. A subset experienced recurrent pain at longer-term follow-up.
CONCLUSION: Pediatric patients with MALS and/or NCS demonstrate consistent clinical features, including abdominal pain and overlapping comorbidities. In this highly selected surgical cohort, open repair was associated with early and intermediate-term patient-reported improvement in compression-related pain, though symptom recurrence was observed in a subset.
METHODS: We conducted a retrospective chart review of 17 pediatric patients who underwent open surgical repair for MALS and/or NCS at a single academic center from 2021-2025.
RESULTS: The most common comorbidities included postural orthostatic tachycardia syndrome (POTS), hypermobile Ehlers-Danlos syndrome (hEDS), gallbladder pathology, and additional vascular compressions. All 17 patients presented with abdominal pain, and more than half reported postprandial pain and/or nausea. Open surgical repair provided patient-reported symptomatic improvement in all patients. A subset experienced recurrent pain at longer-term follow-up.
CONCLUSION: Pediatric patients with MALS and/or NCS demonstrate consistent clinical features, including abdominal pain and overlapping comorbidities. In this highly selected surgical cohort, open repair was associated with early and intermediate-term patient-reported improvement in compression-related pain, though symptom recurrence was observed in a subset.