Median Arcuate Ligament Syndrome (MALS)

Hello, I had MALS surgery 3 months ago. I was doing extremely well up until 1-2 weeks ago. Nausea can be extreme at times. My question is how long is a "full" recovery of the abdomen after surgery such as this? I had my surgery done laparoscopically. My surgeon also stated that he removed a lot of scar tissue during my surgery. I am just wondering if my nerves and abdomen are still healing.

Check on Facebook the group MALS awareness. They have a lot of useful information-sorry to hear you’re having problems.

@jonathand - I’m sorry to hear about your misery. Do you have pain after meals as well? I had same surgery and was fine for a few months, but then the pain returned. The celiac artery never unfolded and I got a stent to keep it open. It works well now. Nausea could have several causes including acid reflux. Check with your doctor if it could be from surgery- maybe they want to check if artery is still parent.

@ethanmcconkey @astaingegerdm

Hi there my brother has been going through severe abdominal pain for 13 months and he has always had digestion issues. Recently he went to the GI who thought it is gastroparesis but he has received no relief and the pain continues to increase especially when he eats or drinks. We finally found out about MALS through a gastroparesis support group. He got a doppler ultrasound and we are waiting for the report but have the images - just not sure how to read it. He ended up in the ER today and they did a CTA with contrast but they don’t see MALS. I of course want another opinion. Can the ultrasound be enough to get diagnose and be a candidate for the celiac plexus block?

@rb4hu - As far as I know an abnormal Doppler ultrasound should be confirmed with a CTA. Since my surgery and stent placement I had follow ups with CTA. However, at my last visit I was told that I can have ultrasound exams. It also depends on the institution doing the test. It is always good to get a second opinion. You would then bring the report on the Doppler and the CTA images. It is possible a vascular surgeon or GI surgeon would have more experience evaluating your brother. If possible, go to a major university medical center. I hope he will get relief soon. I know that pain.

For people who have had surgery with Dr. Hsu, what does he do differently with the nerves of the celiac plexus than just unroofing them, as other surgeons do? People have commented that he takes a different approach to those nerves, which might account for his success. I couldn’t find any medical papers that he might have written explaining the procedure.

Hi 🙂 please i have a guestin for you i was diagnosed MALS and also a nutcracker syndrome.i will have an open surgery on January 30. So in a few weeks. Wh did you have two surgeries and I year recovery? I am really scared .now are you feeling good ? How many ours did the surgery take ? Thanks for every info

Hello - I am a 66 year old male. I had a CT urogram to evaluate a urinary problem and the radiologist saw something suspicious near the celiac branch. I had a CT-A last week which showed a “high grade” stenosis of the celiac artery. I never had symptoms anything near what is described here - no weight loss, diarrhea, etc. I’ve had some discomfort from bloating, gas, GERD, etc., over the years, but nothing that kept me from eating. I saw a local vascular surgeon who didn’t seem overly concerned. Anyone have any comments or suggestions? Thanks.

Check out Mesenteric Artery Ligament Syndrome. There’s also lists of info on MALS Awareness on Facebook

Yes, please check out MALS and see another Dr. You may also want to ask your PCP if he knows of anyone who specializes in MALS. My daughter had surgery 9 years ago for it and again just last Friday, 1/31/2020. With the first surgery for the MALS the surgeon also did a Nissan fundoplication. The surgery she just had they had to repair an esophageal hernia, which was much larger than they anticipated, the Nissan fundoplication came undone so they had to redo that all over, remove scar tissue from the celiac artery, causing MALS ( the ligament had already been cut away ) as well as pyloricgastroplasty. This was done by a general surgeon at a hospital an hour and a half from us as he is the only surgeon in our area that deals with MALS! I wish for her sake that she does not have to go through this again. If she does get MALS again, as surgeon stated he wouldn’t guarantee that she will not have these issues.