Median arcuate ligament syndrome (MALS) is a rare disease caused as a result of extrinsic compression by diaphragmatic fibers arching on the celiac artery at its point of origin from the abdominal aorta. Patients suffering from MALS presented with weight loss, nausea, vomiting, and postprandial epigastric pain. Often misdiagnosed with dyspepsia or acid peptic disease, this syndrome is a diagnosis by exclusion, after excluding commoner causes of the upper abdomen pain. It is diagnosed with computed tomographic (CT) angiography and treated with various modalities, including laparoscopic or open division of fibers of MAL, which cause extrinsic pressure. We report a series of three cases of MALS diagnosed and managed at our center, using laparoscopic division of the fibers and release of the celiac artery.
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