Dunbar Syndrome

Median Arcuate Ligament Syndrome (MALS) also known as Celiac Axis Compression Syndrome (CACS) or Dunbar syndrome which is a very rare condition with an incidence of about 2 cases per 100,000 patients caused by compression of the celiac trunk by the median arcuate ligament . The etiology of Dunbar’s syndrome is not well known as it is rare and is difficult to diagnose and treat. An abdominal CECT in a 22-year-old woman with a 4 months history of postprandial abdominal pain and vomiting showed thickening of median arcuate ligament measuring 6mm causing narrowing of the proximal celiac trunk forming a hooked or a J-shaped appearance suggestive of median arcuate ligament syndrome or celiac artery compression syndrome. After thoroughly ruling out the other causes of the above mentioned symptoms, Laparotomy and release of the median arcuate ligament was done, which resulted in relief of the patient's symptoms. The diagnosis of median arcuate ligament syndrome should be considered in patients with postprandial abdominal pain that does not have a clearly established etiology and surgical decompression/release of median arcuate ligament is the mainstay of management.