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Median Arcuate Ligament Syndrome (MALS)

Digestive Health | Last Active: Oct 29 2:54pm | Replies (1225)

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@jhmontrose

Hi Everyone,
I thought I would jump on here because I found the Facebook group overwhelming. I had surgery for MALS in 2015 (after the usual endless series of "normal" tests) in Seattle and had a couple of good years. And then I started having these random episodes where I'd wake up in the morning with the same pain in the same spot and some increasing nausea. Sometimes I'd even dry heave before it would finally calm down and start to get better. This had become more frequent and frustrating to deal with, probably every 3 days I'd have pain. Fortunately it's not anywhere near as severe as the attacks I would have in 2015 that sent me to the ER 3 times.

Anyway, last Dec I finally decided to seek help. My primary care doc really had no idea what to do with me and the GI specialist she referred me to gave the usual "try taking prilosec for 2 weeks and have a follow up" line, so I did a Google search and found Dr. Mallory Meyer in Denver who actually put MALS down as an area of specialization. Imagine that!

I've now had 2 tests done and the doppler ultrasound came back with the same result as 5 years ago: "Markedly elevated peak systolic velocities in the celiac trunk which worsens during end-expiration" including some signs of stenosis to the superior mesenteric artery (concerning). Then I had a CTA here in my hometown, which came back as normal, but I don't think they did it right as every time they asked me to breathe in deeply. I'm awaiting Dr. Meyer to review these results and get back to me.

In the meantime, I am wondering what experiences folks have had with a second round of surgery? I am suspecting they will make me do yet another test to confirm the results, but it seems pretty clear to me that the first surgery failed somehow. Hopefully Dr. Meyer, being personally interested in MALS, will be much more thorough and have a long-term solution for me so I can get on with my life without pain.

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Replies to "Hi Everyone, I thought I would jump on here because I found the Facebook group overwhelming...."

Hi @jhmontrose

I haven't had my operation yet, but I can empathise with the pain; especially the pain on breathing. Do you think the median arcuate ligament was not cut back enough on the first operation?

Oh no-who did your first surgery? Was it open or lap? I’m so sorry. I had open surgery a year ago and am still having problems. Keep searching for answers. What tests are they doing?