True celiac artery aneurysm secondary to median arcuate ligament syndrome.

Median arcuate ligament syndrome (MALS) is a rare disorder associated with chronic, postprandial abdominal pain and radiographic evidence of celiac artery compression. True arterial aneurysms distal to sites of chronic vascular compression due to post-stenotic dilatation have been described in other anatomic locations such as thoracic outlet syndrome and popliteal entrapment syndrome. We present the case of a patient who presented to vascular surgery clinic with a 35 year history of epigastric abdominal pain and bloating and was found to have a large celiac artery aneurysm with severe compression by the MAL.