Median arcuate ligament syndrome : an unusual cause of chronic abdominal pain

Abstract EN

Chronic abdominal pain is one of the most frequent complaints of subjects visiting the gastroenterologist office and a large majority of these subjects have irritable bowel syndrome (IBS).

Median arcuate ligament syndrome (MALS) is a rare cause of chronic abdominal pain that results from compression or ischemia of the celiac artery by the median arcuate ligament.

Characteristic features include weight loss and postprandial pain, and the diagnosis can be confirmed by radiographic imaging.

Surgical treatment can be curative.

MALS is a diagnosis of exclusion and requires a high level of suspicion.

Herein we present three unique cases of patients with chronic abdominal pain discovered to have MALS and we review the literature.both patients and physicians are left frustrated and without a satisfactory diagnosis.

This case series highlights the importance of including median arcuate ligament syndrome (MALS) in the differential diagnosis when evaluating chronic abdominal pain patients.

MALS is a rare pathological entity that is well described and requires a high clinical suspicion as well as a thorough history and physical exam in order to make an accurate diagnosis.

Appropriate diagnostic testing is necessary to identify MALS since there are multiple treatment options available that may significantly improve a patient’s quality of life.