Malabsorption and abdominal pain secondary to celiac artery entrapment

A patient with abdominal pain was found to have severe compression of his celiac artery on abdominal angiography. Preoperative evaluation with base line and provocative xylose absorption studies were compatible with decreased intestinal blood flow. Surgical division of the median arcuate ligament corrected the intraoperatively determined pressure gradient. Postoperative studies at three months demonstrate absence of celiac artery compression on angiography and normal provocative xylose absorption studies. This case lends support to the existence of the median arcuate ligament syndrome.