COVID-19-Associated Median Arcuate Ligament Syndrome

Median arcuate ligament syndrome (MALS) is a rare disorder resulting from compression of the celiac artery and celiac ganglia which can lead to a myriad of symptoms including postprandial epigastric pain. The reason why some patients become symptomatic and others do not is still under investigation. We conducted a retrospective chart review of 7 patients who developed MALS symptoms approximately 1 month after infection with COVID-19. These patients all presented with abdominal pain which was temporarily relieved by celiac plexus block and most had multiple vascular compressions. Surgery provided symptomatic improvement for these patients. This suggests that patients who develop symptomatic MALS following an infection with COVID-19 should be considered for surgery and assessed for other vascular compressions.