Papers of the Week

We report the unusual presentation of a patient with median arcuate ligament syndrome (MALS) and compression of both the celiac artery (CA) and the superior mesenteric artery (SMA). He underwent a staged treatment. First, a laparoscopic release of the median arcuate ligament was performed. In the second stage, due to persistent post-prandial pain, the SMA was stented resulting in complete symptom relief. Recognizing this rare anatomical presentation is very important to avoiding MALS misdiagnosis and providing the appropriate staged treatment.