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Median Arcuate Ligament Syndrome Experimental and Clinical Observations

James P. Carey, MD; Edward A. Stemmer, MD; John E. Connolly, MD
Arch Surg. 1969;99(4):441-446. doi:10.1001/archsurg.1969.01340160021005.
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Although the existence of abdominal angina as a clinical entity distinct from angina pectoris was proposed in the early 1900's,1 it was not generally accepted even as late as 1931 that intraabdominal pain of vascular origin could occur in the absence of gangrene or peritonitis.2 In 1936, Dunphy3 reported seven patients in whom recurrent attacks of abdominal pain preceded the development of fatal mesenteric occlusion and emphasized the importance of recognizing that transient abdominal pain could result from intestinal ischemia. Mikkelsen,4 in 1957, postulated that abdominal angina could be cured, and intestinal infarction prevented by reestablishing flow through the diseased mesenteric vessels. The advisability of surgical correction of these vascular lesions is now generally accepted.

Atherosclerosis is the most common cause of chronic ischemia to the alimentary tract.5 It is generally believed that as long as the occlusive process is a gradual one, two of


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