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Median Arcuate Ligament Syndrome: A Rare Differential Diagnosis of Chronic Abdominal Pain

João Victor Bonometti1, Pedro Heineberg Muller1, Leonardo Werner Rasche1

  • 1General Surgery, Grupo Hospitalar Conceição, Porto Alegre, BRA.

Cureus
|June 23, 2025
PubMed

Median arcuate ligament syndrome (MALS) is a rare condition caused by the compression of the celiac trunk by the median arcuate ligament. It commonly affects young, thin women and presents with chronic abdominal pain, especially postprandial, and weight loss. We report the case of a 22-year-old female patient with persistent postprandial abdominal pain and significant weight loss. CT angiography revealed compression of the proximal celiac artery. Laparoscopic decompression of the median arcuate ligament was performed with complete symptom resolution and a favorable postoperative outcome. This case emphasizes the importance of including MALS in the differential diagnosis of chronic abdominal pain in young patients. Early surgical intervention can result in significant symptom improvement and enhanced quality of life.

Keywords:
abdominal pain syndromeceliac trunk compressionchronic abdominal painlaparoscopic surgerymedian arcuate ligament

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