The Celiac Artery Compression Syndrome (CACS) is a rare cause of abdominal pain.


Synonym: median arcuate ligament syndrome (MALS)


Pathogenesis: compression of the celiac artery and/or plexus by the insertion of diaphragmatic muscle fibers


Presentation: from early childhood to middle age, often late adolescence or early adult


Females tend to have the condition more than males.


Clinical features:

(1) upper abdominal pain which may be episodic and/or postprandial

(2) weight loss

(3) variable family history

(4) variable vomiting

(5) variable abdominal bruit


Compression of the proximal celiac artery can be seen on imaging studies.


Management may involve surgical release of the median arcuate ligament with or without repair of the celiac artery. Ganglion resection may be necessary to relief persistent neuropathic pain.


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