Laparoscopic Treatment of Median Arcuate Ligament Syndrome:
Median arcuate ligament syndrome (MALS) or celiac artery compression syndrome is a rare disorder caused by compression of celiac artery by the median arcuate ligament. This syndrome was first described by Harjola in 1963.[1] Clinical symptoms include postprandial abdominal pain, nausea, vomiting, epigastric bruit and weight loss. Most of the patients with this syndrome are investigated with several diagnostic procedures and managed as functional gastrointestinal disorder (FGID) before a certain diagnosis is established. Doppler ultrasonography reveals the stenosis/compression of celiac artery with increased flow velocity and computed tomography (CT) angiography confirms the compression of celiac trunk and therefore the diagnosis of MALS. Most of the reports focus on adults in this clinical entity.[2,3] In recent years, MALS has begun to be recognized more frequently in pediatric/adolescent population.[4,5,6]

We report a case of a teenage female patient treated with laparoscopic release of the median arcuate ligament at our institution.

Case Report
A 17-year-old girl with chronic postprandial abdominal pain and weight loss was referred to our clinic. The other causes of chronic abdominal pain were investigated by several studies including gastrointestinal endoscopies and imaging; however, no definitive cause could be identified. Doppler ultrasonography was able to reveal a compression on the celiac artery. Peak systolic velocity (PSV) in the celiac trunk was measured as 250 cm/s, and dropped to 170 cm/s with deep inspiration (?PSV = 80 cm/s). Diagnosis was confirmed by three-dimensional (3D) CT angiography confirming the narrowing of celiac artery at the beginning of the celiac trunk arising from abdominal aorta....