An Atypical Presentation of Median Arcuate Ligament Syndrome

Another Sherlock Holmes Mystery: Abdominal Pain Explained by Median Arcuate Ligament Syndrome

“…Epigastric pain has been the most reported symptom in 100% of patients, weight loss in 48% to 67% of patients, and nausea and diarrhea in approximately 8% to 10% of patients. 8 - 10 …”

“…Most importantly, patients who underwent surgical decompression experienced immediate postoperative relief in an estimated 80% of patients. 9 Coelho et al, assessed the outcome of patients’ status post-laparoscopic treatment of MAL, all were found to be asymptomatic at a 3-month follow-up. 10 …”

“…Epigastric pain has been the most reported symptom in 100% of patients, weight loss in 48% to 67% of patients, and nausea and diarrhea in approximately 8% to 10% of patients. [8][9][10] The MALS can be detected in a percentage of the population who are asymptomatic. The workup focuses on ruling out the more common etiologies of upper abdominal pain such as peptic ulcer disease, gastritis, intestinal ischemia, inflammatory bowel disease, and gallbladder problems.…”

“…13 Most importantly, patients who underwent surgical decompression experienced immediate postoperative relief in an estimated 80% of patients. 9 Coelho et al, assessed the outcome of patients' status post-laparoscopic treatment of MAL, all were found to be asymptomatic at a 3-month follow-up. 10 Our patient's presentation was atypical in that her pain was both epigastric and left upper quadrant pain, which made establishing the diagnosis even more clinically challenging.…”