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Case Reports
. 2022 Feb 10;14(2):e22106.
doi: 10.7759/cureus.22106. eCollection 2022 Feb.

Median Arcuate Ligament Syndrome

Taylor P Iobst  1   2 , Kelsey M Lamb  1   2 , Stacy L Spitzer  1   2 , Ravi N Patel  1   2 , Sameer S Alrefai  1
Affiliations
Case Reports

Median Arcuate Ligament Syndrome

Taylor P Iobst et al. Cureus. .

Abstract

Median arcuate ligament syndrome (MALS) is uncommon and often difficult to diagnose due to the vague presenting symptoms of abdominal pain, weight loss, and early satiety. Here, we report the case of a 63-year-old man who was successfully treated with laparoscopic median arcuate ligament release. Computed tomography (CT) of the abdomen and pelvis performed preoperatively demonstrated compression of the celiac artery with post-stenotic dilatation consistent with MALS. Subsequently, laparoscopic median arcuate ligament release was performed without any complications. Postoperatively, the patient reported resolution of abdominal pain with increased appetite and weight gain. Nonspecific abdominal pain and weight loss may raise concern for malignancy, but MALS should also be considered in the differential diagnoses. Diagnosis can be confirmed with CT and/or angiography. Median arcuate ligament release results in partial if not complete resolution of symptoms due to decompression of the celiac artery as well as division of the overlying celiac plexus.

Keywords: celiac axis; laparoscopy; median arcuate ligament release; median arcuate ligament syndrome; nonspecific abdominal pain.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Preoperative CT of the abdomen/pelvis demonstrating celiac artery stenosis with post-stenotic dilatation consistent with MALS.
CT: computed tomography; MALS: median arcuate ligament syndrome
Figure 2
Figure 2. Postoperative CT scan of the abdomen/pelvis showing no evidence of celiac artery compression.
CT: computed tomography
See this image and copyright information in PMC

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