# Laparoscopic median arcuate ligament release: Successful management of Dunbar syndrome in a young male

## TL;DR

A 24-year-old man with chronic abdominal pain and weight loss was successfully treated with laparoscopic surgery for a rare condition called Dunbar syndrome.

## Contribution

This case demonstrates the successful use of laparoscopic surgery for MALS in a young male and a resource-limited setting.

## Key findings

- Laparoscopic median arcuate ligament release with celiac neurolysis successfully treated MALS in a 24-year-old male.
- The patient was symptom-free at 6-month follow-up after minimally invasive surgery.
- Laparoscopic approaches are feasible and effective even in resource-constrained environments.

## Abstract

Median arcuate ligament syndrome (MALS), also known as Dunbar syndrome, is a rare condition caused by compression of the celiac artery and/or ganglion by the median arcuate ligament. Its incidence is poorly defined, but it typically affects lean, middle-aged women. Due to its non-specific symptoms, MALS is often underdiagnosed. Although open surgery is conventional in resource-limited settings, laparoscopic approaches offer favorable outcomes.

We report a case of a 24-year-old male with chronic postprandial upper abdominal pain and significant weight loss. Imaging via contrast-enhanced CT confirmed celiac artery compression consistent with MALS. He underwent successful laparoscopic median arcuate ligament release with celiac neurolysis.

MALS presents diagnostic challenges due to its overlapping symptoms with other gastrointestinal disorders. Imaging and clinical correlation are crucial for diagnosis. While open surgery remains common in low-resource settings, laparoscopy provides reduced morbidity and quicker recovery.

This case highlights the importance of considering MALS in chronic postprandial pain and supports the feasibility of laparoscopic decompression as an effective treatment, even in resource-constrained environments.

•24-year-old male with postprandial pain, weight loss, diagnosed as Median Arcuate Ligament Syndrome.•Contrast CT confirmed celiac artery compression consistent with MALS.•Laparoscopic ligament release with celiac neurolysis done successfully.•Minimally invasive surgery proved feasible even in resource-limited setup.•Uneventful recovery; patient symptom-free at 6-month follow-up.

24-year-old male with postprandial pain, weight loss, diagnosed as Median Arcuate Ligament Syndrome.

Contrast CT confirmed celiac artery compression consistent with MALS.

Laparoscopic ligament release with celiac neurolysis done successfully.

Minimally invasive surgery proved feasible even in resource-limited setup.

Uneventful recovery; patient symptom-free at 6-month follow-up.