Trans-Esophageal Echocardiography of the Descending Aorta and Celiac Trunk as an Intraoperative Monitoring for Median Arcuate Ligament Syndrome (MALS) Treatment: Technique Proposal and Two Case Reports

Dunbar syndrome is caused by the compression of celiac artery median arcuate ligament (MAL) and diaphragmatic crura, presenting with abdominal pain. The treatment surgical, aim dissecting separating crura from axis, restoring blood flow in trunk. We propose use transesophageal echocardiography to measure peak systolic velocity trunk evaluate, real time, efficacy surgery during MAL resection. Two clinical cases practical implications are reported. In one these, ultrasound exam was useful providing an intraoperative confirmation outcome