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Median Arcuate Ligament Syndrome (MALS)
Digestive Health | Last Active: 2 hours ago | Replies (1229)Comment receiving replies
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.
Replies to "Hi Everyone- @kariulrich My mother has been battling chronic abdominal pain for almost 4 years now...."
@dave06351 @katy1921 I agree with what Dave wrote above. MALS is caused by a ligament causing stenosis, however other vascular issues maybe present for your Mom that have the same symptoms as MALS. It sounds like she has had an extensive work up, but I do not see that anyone has addressed any vascular issues as a possible cause of her problems. Has she seen a vascular doctor at all? I would be curious to know if she had elevated velocities of any of her abdominal arteries on doppler ultrasound. This is a non-invasive test that could give the doctors a better picture of what is happening. Several vascular problems lead to abdominal/intestinal angina angina. It maybe coincidence that her symptoms appeared at the same time of her surgery, however it is something that needs to be noted. Further work up is needed, as a celiac block is helpful for the pain but it does not tell you the cause. Do you have a vascular doctor in your area?
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MALS can occur when two simultaneous conditions are prevalent. Aggravation of the Celiac Ganglion & the Median Accurate Ligament being in a location that can cause it to collapse the celiac artery or chafe it. It's possible that the surgery did aggravate the Celiac Ganglion; but, should not be a continuous problem.
Obviously, you need to keep on the surgeon that did the work and have him straigthen up since it happened under his hand.