Laparoscopic management of the median arcuate ligament syndrome

Background: The median arcuate ligament syndrome (MALS) is an infrequent cause of abdominal pain. This diagnosis is made after exclusion of other more common causes of upper abdominal symptoms. Mesenteric duplex and a computerized tomography mesenteric angiography demonstrate dynamic compression of the coeliac axis during expiration. Methods: Retrospective analysis of presenting symptoms, preoperative findings and postoperative outcomes. Results: Five consecutive patients who underwent laparoscopic division of the median arcuate ligament over a 4‐year period (2006–2010) are presented. This procedure was associated with low morbidity and complete relief of symptoms in all patients. Conclusion: A minimally invasive procedure is the treatment of choice in selected patients with MALS.