Median Arcuate Ligament Syndrome: A Hidden Cause of Abdominal Pain

Median arcuate ligament syndrome (MALS) is an uncommon condition where the median arcuate ligament compresses the celiac artery, leading to reduced blood flow. It commonly presents with upper abdominal pain after eating, unintentional weight loss, and an audible abdominal bruit. Since MALS is a diagnosis of exclusion, early identification and timely intervention are crucial in enhancing the patient's quality of life. A 43-year-old female presented with chronic postprandial epigastric pain, weight loss, and intermittent nausea for 3 months. The pain was described as dull and worsened after meals. MALS is a rare vascular compression syndrome that mimics other gastrointestinal disorders, often causing delayed diagnosis. Imaging techniques such as Doppler ultrasound, computed tomography angiography, and magnetic resonance angiography aid in diagnosis. Surgical decompression, primarily via laparoscopic median arcuate ligament release, is the preferred treatment and has shown significant symptom relief. MALS is a rare but treatable cause of chronic abdominal pain. A multidisciplinary approach and timely intervention are crucial for optimal patient outcomes.