The median arcuate ligament syndrome (MALS) is a is a rare condition where the median arcuate ligament, a band of tissue under the diaphragm, compresses the celiac artery and surrounding nerves leading to chronic abdominal pain.1,2 The compression of the celiac artery and/or the celiac plexus nerves by the diaphragm can result in pain that is worsened with eating or sometimes with exercise. Other symptoms include nausea and weight loss. In some people the symptoms can be devastating and can lead to incorrect diagnoses of an eating disorder, psychiatric conditions, or functional abdominal pain (e.g. irritable bowel syndrome, abdominal migraine).1,2,3 This condition affects both children and adults.4,5 The diagnosis is made based on a combination of the clinical symptoms and radiology imaging.1, 6,7,8.9 Treatment may include a surgical procedure that is effective in approximately 60-80% of patients.3
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