 Good morning to respected delegates. I am Dr. Aditya Rakeshnalavde, junior resident MD radio diagnosis of Dr. D. Vipartil Medical College, Nai Mumbai. The title of my paper is Median Arcute Ligament Syndrome, which is a rare cause of chronic abdominal pain. Aim was to evaluate the patients with chronic abdominal pain with Median Arcute Ligament Syndrome, a rare syndrome detected incidentally on routine computer tomography of abdomen pelvis. On our multi-detecter CT scanner GE Optima 128 slice, imaging protocol for CT abdomen and pelvis includes intravenously administered contrast material using 128 ml of non-ionic contrast agent injected at a rate of 3 ml per second. Scans are obtained during both the arterial and venous phases to ensure a pacification of arteries and veins. Multi-planar 3D imaging is also valuable in identifying the hemodynamic significance of the narrowing and is important for planning the treatment. Median Arcute Ligament Syndrome is characterized by dynamic compression of the proximal celiac artery by the Median Arcute Ligament, which is a fibrous arch that unites the diaphragmatic crura on the either side of the AOT hiatus, which leads to post-prandial epigastic pain and vomiting. These symptoms are usually non-specific and are easily misdiagnosed. This focal narrowing has a characteristic hooked appearance which helps to distinguish this condition from other causes of celiac artery narrowing such as atherosclerotic disease. Median Arcute Ligament Syndrome is one of the abdominal vascular compression syndromes which was initially described by Herjola in 1963. It usually affects young women in the age group of 22-40 years. It is also known as Danbar Syndrome, named after the radiologist JD Danbar. The patients presented with upper abdominal pain, nausea, which lasted for months. Pain and nausea usually presented after meals. These patients underwent various routine workup like laboratory investigations and ultrasonography of abdomen. Also gastroenterology workup, which included an upper GI endoscopy, were done, which were all inconclusive and therefore CT scan of abdomen and pelvis was advised. The classical finding on CT included narrowing in the proximal celiac artery with inferior displacement due to indentation by Median Arcute Ligament resulting in characteristic hook configuration. Additional features included post-genotic dilatation of the celiac artery. It was best appreciated on sagittal images and can be easily overlooked on axial images. The typical hook configuration helps to differentiate Median Arcute Ligament syndrome from atherosclerosis. These were sagittal and axial images of the patient that was screened, in which we could see a classical hooked appearance of the Median Arcute Ligament syndrome around the median celiac artery and post-genotic dilatation of the celiac artery. These are the three-dimensional reconstructed sagittal images, which showed the same. CT is considered to be gold standard imaging modality for detection of proximal celiac artery stenosis with classic hooking configuration. CT is best evaluated in an inspiratory phase since Median Arcute Ligament is attached to diaphragm. Movement occurs with respiration and two true compression can be evaluated in the end inspiratory phase. The patients presented with extensive compression of celiac artery leading to post-prandial epigastic pain, nausea and vomiting. These symptoms are usually non-specific and easily misdiagnosed as functional dyspepsia, peptic ulcer disease or gastropathy. When these patients showed that Median Arcute Ligament syndrome might be a cause of their recurrent abdominal pain. These are my references. Thank you.