Median Arcuate Ligament Syndrome

HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around

ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.

HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now

The symptoms adults experience are much the same as the children experience without the stunning of growth and affect on puberty. Some adults having a mild form of the disease exhibit almost no symptoms. Others may experience a loss or gain in appetite, abdominal pain, bloating, gas or indigestion. In addition, other people have bothersome symptoms including diarrhea, weight loss, abdominal discomfort, and excessive gas caused by vitamin and nutrient deficiencies (The Mayo Clinic staff, 2011).

T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.

History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and

Experiencing nausea, vomiting, and eventually swelling. Within just a few days of contracting this terrible

Mr. Clifford a 57 years old Hispanic patient presents to the urgent care, complaining of episodic epigastric discomfort, which he describes it usually begins a few hours after eating a meal. The patient, also reports other symptoms such as heartburn, bloating, abdominal fullness and indigestions. The patient reports the pain wakes him up at night and he feels some relief after taking antacids. Mr. Clifford agrees to take aspirin prophylactic

This patient presented to the emergency department (ED) with pain in his upper right quadrant and flank. He reported experiencing abdominal distention

I was happy that I managed to rule out any distinct causes of the abdominal pain by performing the examination to collect data, analyse it, and use the results to make an appropriate decision (Schon, 1984). However, had I performed the examination without assistance I may not have gained all the information required to confirm diagnosis, as I did forget some aspects.

The injuries of Med. Collateral Lig. are divided into grades: grade one tears that involve a few MCL fibers with localized tenderness. Grade two tears involve disruption of more MCL fibers with generalized tenderness . Grade three tears are complete tears resulted in laxity of the medial joint to valgus stress. (FIG.14) ( 69

Steven Claes is known to have discovered a new ligament in our knee that could supply us with explanations to many unanswered questions. First, what is a ligament? Ligaments are bundles of connective tissue that connect one bone to an adjacent bone, or from one bone to a bone next to it. These ligaments are crucial in preventing unwanted and damaging movements such as . They are also important in maintaining stability of the joint while it is in motion. The ALL or anterolateral ligament, is a newly found ligament located in the knee joint. It is located towards the front of the knee and is known to be an important restraint of internal tibia rotation. This ligament is situated at the prominence of the lateral femoral epicondyle slightly anterior to the origin of the lateral collateral ligament, also known as the LCL. It has firm attachments to the lateral meniscus enveloping the inferior lateral geniculate artery and veins. This ligament connects the .. scientific name or in other terms, the thigh bone to the shin bone. Due to the location of this ligament, researches believe it keeps the knee from an unwanted inward motion. The anterolateral ligament is said to have an effect on the rotational

In 1963, Harjola3 described a case of chronic abdominal pain in a young woman that he attributed to mesenteric ischemia caused by extrinsic compression of the celiac artery. Since then, the topic has been the focus of numerous controversies regarding its pathophysiology, definitive diagnosis, and optimal treatment4. There is still considerable doubt about the real existence of the CACS. Asymptomatic compression or stenosis of the celiac artery is common, and compression of this artery by fibers of the median arcuate ligament has been demonstrated on arteriography in asymptomatic patients1. Similarly, autopsy studies have shown that the celiac artery is compressed by the median arcuate ligament in up to one-third of individuals5. The difficulty