Median Arcuate Ligament Syndrome (MALS)

Hi guys. I am a 23 year old female! I have been experiencing lots of symptoms over the last 6-7 months and have got no answers. It started out in December with very horrible abdominal pain that radiated to my back, nausea,fatigue, SOB and vomiting. After being seen in the ER that night they did an ultrasound and blood work to rule out gall bladder issues .Gall bladder came back fine. Was prescribed narcos and told to follow up with a primary care provider. While following up with my primary care doctor she did additional blood work and thoroughly checked my liver and what not. Everything came back perfect. She then referred me to see a GI specialist and he ordered an Endoscopy. Ever since the beginning of December I lost 15lbs, could barely eat and had nausea for 3 months straight. The Endoscopy was done in the beginning of February. Results came back with mild gastritis and possible gastroproieses. The shortness of breath would come and go with the abdominal pain. The only way to relieve the pain was medication and laying flat on my back while stretching out. Was also referred to a Pulmonolgist to rule out asthma and anything breathing issues associated with the SOB. Here I am today with no answers.. but I know something isn't right with my body. Pain is right under my sternum and feels like there is a rubber band pinching or holding something. Next steps I believe my GI DR wanted to do are imaging on my abdomen area and being seen by a cardiologist. Seems like a lot of my symptoms are similar to your guys symptoms! Im sorry you guys all have to go through this. It really can put you down and make you want to feel like doing nothing. I am hoping to get answers soon. Should I mention MALS to my DR or just let him run his tests and see? I feel like a lot of missed diagnoses go missed sometimes.

Thanks guys!

Thanks for the quick response! I will definitely be straight forward. As to what you were saying about the autonomic nervous system that totally makes sense for the palpitations and shortness of breath. Do you also have a burning or warm feeling under the sternum? My pain comes and goes a lot too. It sucks that to see all these specialist it takes weeks to get in. I am so ready to be out of pain and being uncomfortable..

Thanks for the quick response! I will definitely be straight forward. As to what you were saying about the autonomic nervous system that totally makes sense for the palpitations and shortness of breath. Do you also have a burning or warm feeling under the sternum? My pain comes and goes a lot too. It sucks that to see all these specialist it takes weeks to get in. I am so ready to be out of pain and being uncomfortable..

Hi guys. I am a 23 year old female! I have been experiencing lots of symptoms over the last 6-7 months and have got no answers. It started out in December with very horrible abdominal pain that radiated to my back, nausea,fatigue, SOB and vomiting. After being seen in the ER that night they did an ultrasound and blood work to rule out gall bladder issues .Gall bladder came back fine. Was prescribed narcos and told to follow up with a primary care provider. While following up with my primary care doctor she did additional blood work and thoroughly checked my liver and what not. Everything came back perfect. She then referred me to see a GI specialist and he ordered an Endoscopy. Ever since the beginning of December I lost 15lbs, could barely eat and had nausea for 3 months straight. The Endoscopy was done in the beginning of February. Results came back with mild gastritis and possible gastroproieses. The shortness of breath would come and go with the abdominal pain. The only way to relieve the pain was medication and laying flat on my back while stretching out. Was also referred to a Pulmonolgist to rule out asthma and anything breathing issues associated with the SOB. Here I am today with no answers.. but I know something isn't right with my body. Pain is right under my sternum and feels like there is a rubber band pinching or holding something. Next steps I believe my GI DR wanted to do are imaging on my abdomen area and being seen by a cardiologist. Seems like a lot of my symptoms are similar to your guys symptoms! Im sorry you guys all have to go through this. It really can put you down and make you want to feel like doing nothing. I am hoping to get answers soon. Should I mention MALS to my DR or just let him run his tests and see? I feel like a lot of missed diagnoses go missed sometimes.

Thanks guys!

Kali, I first need to say thank you for being involved with all of our problems with MALS. Secondly; I need to ask, how dire is MALS symptoms for everyone. I've been diagnosed after physical exam, CT angiogram for anatomy only, and a celiac plexus block. It seemed like we would need more tests than this, other than history of mild gastric emptying; 14% gallbladder function and removal. But, Dr. Hsu said that's all we need. I feel like my symptoms are much more dire than a the anatomy of this issue. I almost feel like a completely detached a ligament in my diaphragm and I'm suffocating. Now, I had a chest x-ray after my block and I assume that means my diaphragm is properly attached. But, How does MALS just happen out of the blue? I would think the geometry would have needed to change to cause the agrivation and restriction of the Celiac artery.

Kali, I first need to say thank you for being involved with all of our problems with MALS. Secondly; I need to ask, how dire is MALS symptoms for everyone. I've been diagnosed after physical exam, CT angiogram for anatomy only, and a celiac plexus block. It seemed like we would need more tests than this, other than history of mild gastric emptying; 14% gallbladder function and removal. But, Dr. Hsu said that's all we need. I feel like my symptoms are much more dire than a the anatomy of this issue. I almost feel like a completely detached a ligament in my diaphragm and I'm suffocating. Now, I had a chest x-ray after my block and I assume that means my diaphragm is properly attached. But, How does MALS just happen out of the blue? I would think the geometry would have needed to change to cause the agrivation and restriction of the Celiac artery.

Hi Everyone- @kariulrich My mother has been battling chronic abdominal pain for almost 4 years now. Long story short, she felt a weird pain once in her abdomen and mentioned it to her gyno and it led to finding pre-cancerous nodules in her pancreas. She has pancreatic surgery to remove part of her pancreas and her entire splein as a precaution. It was deemed she did not have pancreatic cancer and still does not today. Since then, she has been battling awful pain when she eats, immense weight loss, etc. A year ago she had her gallbladder removed as they thought it would solve it, and it did not. This week, she had celiac plexis block surgery to tackle the pain (again, another surgery designed for pancreatic cancer patients, but without her actually having the cancer). She is much worse since the surgery and no one can seem to figure out why. I came across MALS in my online research, but could not find the answer to this question - can MALS occur as a result of something going wrong during pancreatic surgery?

My mom did not have any issues eating, beyond a regular occasional bad stomach as you would expect with age. The doctor seems to think he messed something up this week in surgery and now I am wondering if she might have this as a result of something occurring in her original surgery a few years ago. Any insight would be much appreciated.

Hi Everyone- @kariulrich My mother has been battling chronic abdominal pain for almost 4 years now. Long story short, she felt a weird pain once in her abdomen and mentioned it to her gyno and it led to finding pre-cancerous nodules in her pancreas. She has pancreatic surgery to remove part of her pancreas and her entire splein as a precaution. It was deemed she did not have pancreatic cancer and still does not today. Since then, she has been battling awful pain when she eats, immense weight loss, etc. A year ago she had her gallbladder removed as they thought it would solve it, and it did not. This week, she had celiac plexis block surgery to tackle the pain (again, another surgery designed for pancreatic cancer patients, but without her actually having the cancer). She is much worse since the surgery and no one can seem to figure out why. I came across MALS in my online research, but could not find the answer to this question - can MALS occur as a result of something going wrong during pancreatic surgery?

My mom did not have any issues eating, beyond a regular occasional bad stomach as you would expect with age. The doctor seems to think he messed something up this week in surgery and now I am wondering if she might have this as a result of something occurring in her original surgery a few years ago. Any insight would be much appreciated.