A Case of Median Arcuate Ligament Syndrome Managed by Laparoscopic Surgery and Additional Endovascular Treatment: Report of a Case

Abstract

Median arcuate ligament syndrome (MALS) is a rare cause of abdominal pain and weight loss, which is likely caused by compression of either the celiac artery (CA) or plexus by the median arcuate ligament. A case of MALS in a 25-year-old female with severe postprandial pain and weight loss is herein described. An imaging study demonstrated the abnormal “stealing” of the blood flow from the superior mesenteric artery (SMA) circulation through the pancreaticoduodenal arcade to the hepatic circulation, which was corrected by laparoscopic dissection of the MAL followed by percutaneous transluminal angioplasty (PTA) of the CA.