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Median Arcuate Ligament Syndrome (MALS)

Digestive Health | Last Active: 5 hours ago | Replies (1229)

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@red1955

I was diagnosed with MALS in 2016, at the age of 61 when my GI doctor ordered a CTA due to the exclusion of other gastrointestinal issues. In 2019 my symptoms grew significantly more problematic. They included chest pain,irregular heartbeat, breathlessness, dizziness, severe epigastric pain that was not necessarily postprandial, loss of appetite, nausea, diarrhea, significant gas and bloating and generally feeling uncomfortable. Another CTA was completed showing severe Celiac artery stenosis suggestive of MALS, Superior mesenteric artery stenosis, FMD of right renal artery and pelvic vascular congestion. A vascular surgeon performed an open laparotomy and lysis of the celiac fibrinous plexus. A CT was performed after surgery due to uncontrollable pain and was normal. Post-surgery I continue to experience significant epigastric pain, postprandial and otherwise, gas, bloating, and diarrhea for 3 1/2 weeks. The pain felt like someone was roughly performing the Heimlich maneuver on me. It also felt like my epigastric area was being pulled apart and often radiated down my right side to the mid back. After numerous trial's of gastric medicine, hydrocodone, and neurontin, I realized the pain was best controlled with Neurontin, indicating the pain is nerve-related. I have had several bouts of regional complex pain syndrome after brachial plexus release surgery and hand and foot fractures. I'm unsure if the pain is caused by residual nerve fibers post-surgery or a CRPS recurrence. My vascular surgeon has basically discharged me at 4 weeks post op, but offered a referral to a pain management doctor for a celiac plexus block. I am concerned with the FMD of the right renal artery and the underlying reason that I have both CACS and FMD. I wish I would have gone to the Mayo Clinic but I have Medicare and Blue Cross Blue Shield of Louisiana.

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Replies to "I was diagnosed with MALS in 2016, at the age of 61 when my GI doctor..."

@red1955 - Sorry to hear about the continued pain postop. I had my MALS surgery 2015 at MUSC in Charleston. I also had significant pain postop - well controlled with neurontin. It faded away after a few months. I was a patient at Mayo earlier. I had Medicare and a supplemental insurance. Mayo fills the insurance forms and then we forward the insurance payment to them. I have been lucky to have everything covered. You could still go to Mayo for your continued problems.