MISLEADING POST PRANDIAL PAIN: MEDIAN ARCUATE LIGAMENT SYNDROME REVIEW OF LITERATURE AND CASE REPORT

Abstract

Introduction:Median arcuate ligament syndrome (MALS) is a rare disease with different names. Patients are usually young females, presenting with abdominal pain and weight loss. The symptoms are caused by compression of the celiac artery by the median arcuate ligament. Case report: A 35-year-old male patientwas admitted as a case of COVID, with a chronic history of postprandial abdominal pain. The patient was treated before for a helicobacterpylori infection after presentation with the same complaint. When he resolved his COVID condition, an abdominal computed tomography incidentally showed celiac artery stenosis with a hooking appearance. He underwent a laparoscopic release. Interestingly, he was readmitted after 25 days and diagnosed to have Addisons disease. Discussion: Due to the syndromes rarity, it is usually diagnosed after the exclusion of more common differentials. Although that the European Society for Vascular Surgery (ESVS) is considering MALS as the most common cause of single-vessel arterial stenosis. The diagnosis is made through the presentation of radiological evidence of celiac trunk compression. The release is the mainstay of treatment for the best outcome and is trending nowadays to be by the laparoscopic procedure. Conclusion: There is not enough MALS awareness, and there are needs to be established. This can happenthrough more proper case reviews, trials of new approaches, and management.