Median Arcuate Ligament Syndrome Misdiagnosed as Cannabis Hyperemesis Syndrome: A Case Study September 15, 2026 Annals Of Internal Medicine: Clinical Cases Share Summary Takeaways Insight Report Clinical Scorecard Quiz Poll 1 A 25-year-old woman was initially misdiagnosed with cannabis hyperemesis syndrome after experiencing recurrent gastrointestinal symptoms. 2 Imaging revealed significant celiac artery compression due to median arcuate ligament syndrome, confirmed by duplex ultrasonography. 3 Median arcuate ligament syndrome often overlaps with other gastrointestinal disorders, complicating accurate diagnosis. 4 The patient declined surgical intervention and experienced symptom exacerbations during a subsequent pregnancy. 5 Greater awareness of median arcuate ligament syndrome is necessary to reduce diagnostic delays and improve patient outcomes.