Restoration of luminal patency of the celiac artery after division of the median arcuate ligament in an adolescent with median arcuate ligament syndrome presenting with celiac artery occlusion

We present the case of an 18-year-old woman diagnosed with median arcuate ligament syndrome (MALS) who presented with celiac artery (CA) occlusion. An open surgical approach was used, the MAL was released, and luminal patency was restored in the CA. The patient's symptoms were completely relieved. Computed tomography angiography performed 5 weeks postoperatively demonstrated sustained luminal patency of the CA. The sine qua non of MALS is the presence of severe compression of the CA. CA luminal patency can be restored in adolescent patients with MALS presenting with CA occlusion by ligament release alone avoiding the need for more complicated CA revascularization. This finding has not been described previously in the contemporary MALS literature.