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Severe Post-prandial Pain: A Case Report
Nandita Kakar1, Harrison C Smith1, David L Crawford2
1Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Cureus
|March 29, 2022
Summary
Median arcuate ligament syndrome (MALS) causes abdominal pain from celiac artery compression. Diagnosis requires excluding other conditions, and surgery offers significant symptom relief.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Median arcuate ligament syndrome (MALS) is a rare condition causing post-meal abdominal pain.
- It results from the median arcuate ligament compressing the celiac artery and plexus.
- Symptoms include nausea, vomiting, diarrhea, and weight loss, mimicking other abdominal issues.
Observation:
- Radiologic compression of the celiac axis occurs in 10-24% of individuals.
- Symptomatic compression, however, is present in about half of those with radiologic findings.
- MALS is a diagnosis of exclusion due to nonspecific, overlapping symptoms.
Findings:
- Angiography with breathing maneuvers is the gold standard for diagnosing MALS.
- Surgical division of the median arcuate ligament effectively decompressing the celiac artery.
Implications:
- Surgical decompression provides substantial symptomatic relief for MALS patients, with 60-70% experiencing improvement.
- Accurate diagnosis and surgical intervention are crucial for managing this rare condition.
- Further research may elucidate the precise mechanisms and optimize diagnostic criteria.
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