Median Arcuate Ligament Syndrome (MALS) - A Complex Curable Entity

Median arcuate ligament syndrome (MALS) also known as celiac artery compression syndrome, or Dunbar syndrome is a rare condition characterized abdominal pain attributed to compression of the celiac artery and the celiac ganglia by the median arcuate ligament. The abdominal pain may be associated with meals, weight loss or abdominal bruit heard by clinician. MALS is diagnosis of exclusion as a healthy individual may have some degree of celiac compression. Screening for MALS is done with Ultrasound, computed tomography (CT) or magnetic resonance (MR) angiography. Here we present a patient who came to OPD with complaints of pain in abdomen increasing post meal, was found to have raised Blood pressure in right arm sitting postion, where as it was a different reading in another arm. After investigations, in CT Aortogram suggestive of focal constrictions in the descending thoracic aorta along with focal narrowing noted at the origin of celiac axis due to mass effect caused by median arcuate ligament – MALS.