Pediatric Abdominal Vascular Compression Syndromes: Clinical Presentation, Comorbidities, & Outcomes Following Surgical Correction, 2026, Mahan et al.

[Chandelier]

Pediatric Abdominal Vascular Compression Syndromes: Clinical Presentation, Comorbidities, and Outcomes Following Surgical Correction

Mahan, David S.; Brandeis, Benjamin; Nagarsheth, Khanjan H.

Abstract:​

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.

Web | DOI | Annals of Vascular Surgery | Paywall