A rare case of median arcuate ligament syndrome: a case report and review of literature

Introduction and importance: MALS is a rare condition where the celiac trunk is compressed by the median arcuate ligament, typically presenting with postprandial abdominal pain and weight loss; vomiting may occur less frequently. Case presentation: A 43-year-old female patient came to our center with mild postprandial abdominal pain in the epigastric region and a bloating sensation. Abdomen ultrasonography revealed hepatomegaly with fatty liver grade I and a computed tomography scan showed U-shaped stenosis of the proximal coeliac trunk just distal to its origin: Findings suggestive of median arcuate ligament syndrome. The patient underwent laparoscopic release of the median arcuate ligament. Discussion: The diagnosis of Median Arcuate Ligament Syndrome is made based on typical post-prandial symptoms and abdominal imaging techniques such as Doppler ultrasonography, computed tomography angiography, or magnetic resonance angiography. Other potential intestinal disorders should be ruled out before confirming the diagnosis. The primary treatment for this condition is celiac artery decompression through various methods. Conclusion: Median arcuate ligament syndrome should be considered in patients with unexplained post-prandial abdominal pain. The treatment involves celiac artery decompression through the release of the median arcuate ligament.