Median Arcuate Ligament Syndrome (MALS)

Hi all, I just wanted to give a positive update. I had a 3rd (yes 3rd!) MALS surgery last week with Dr. Sprouse in TN, who has done around 100 MALS surgeries. He did a catheter angiogram and found that there was a remaining spot of compression on my celiac artery, almost completely blocking it. His opinion is that the prior surgeons did not follow the entire course of the artery from where it branches off the aorta and all of its branches.. My stomach has been 100% better and I feel like I can breathe deeply again. The incision pain is my only issue since surgery. Hopefully this will be lasting relief, but we will keep following up with ultrasound to be sure the artery stays open. My advice to anyone going through MALS the first time or still not getting relief: keep pushing for answers and work with an experienced MALS surgeon.

Ralph-Mayo has not been known to treat Mals correctly. Go to Facebook and join MALS awareness. There is a wealth of information which is how I found a diagnosis after 16 years of doctors tell me it was nothing. Unless you address the ligament and cut it back to the spine and address the nerves you will always have problems Hope to see you there!

@jhmontrose - Such great news!! Such a shame it took 3 surgeries to repair- how did you find this surgeon?
I’m so happy for you!

@lety83 - Have you had follow up visit after surgery? I don’t think you should have pain after eating at this point. It is possible that your celiac artery is still not fully open.
It happened to me after 6 months- the artery was still deformed from the ligament pressure. A stent was placed and I have been fine since then.
You probably should contact the surgeon to make sure blood flow is good.

I found him through MALS Pals on Facebook. That group has a list of MALS surgeons. Also I started searching the group history for surgeons who had done revisions. I found mentions of Dr. Sprouse as being a "scar tissue expert" which I knew would be a major issue reoperating on me. But it was really his patients, one in particular who encouraged me to see about an appointment. I ended up consulting 4 surgeons and he was the one I felt most comfortable with. At this point I'm hoping all I ever need in the future is a stent, and he will be doing ultrasounds to be sure the artery has stayed open.

Hi, I also had an incomplete recovery from MALS surgery last year. I would recommend you reach out to your surgeon and let them know you're still experiencing symptoms. If this continues, you may need to get repeat ultrasound to see if the artery is open or recompressed.

Doctor said, to wait 6 months to see if surgery worked. He explained that only 3 out of the 10 he performed surgery on has seen relief. I had laparoscopic surgery in November. I am currently trying acupuncture. Doctor wants me to see psychiatrist now because I’ve been sick for a year. What is the purpose of the stent? Was that surgery? Sorry I’m new to all this. So after 6 months you got sick again? What were you’re symptoms?

Thank you, I did informed him that I’m still in pain after I eat. He said, wait 6 months after surgery to see if surgery worked. Out of his 10 patients he performed surgery on only 3 got better. How long after surgery did your symptoms return? I am currently trying acupuncture. I’m can’t take this anymore. I want to be able to eat normal without getting pains. I’m tired of smoothies. So are you 100% better now?

My surgeon gave me a 50-50 success rate. After 5-6 months the pain returned. I contacted their office and they scheduled a CT angiogram. It showed that the artery had not been able to expand to normal size- the pressure from the ligament had caused a more or less abnormal deformity. I saw a vascular surgeon too who recommended placement of a stent. They did not have to do a laparoscopic surgery for this, but went through an artery to place the stent. Follow up scans were clear.
I had to be on blood thinners for a while.
It was explained to me that if stent didn’t work they could perform a bypass.
I don’t know the time one has to wait to see if surgery was successful. There could still be swelling in the area from the surgery.
They should do an ultrasound or CT angiogram to check the artery.
If there is a problem you should see a very good vascular surgeon.
I have seen a therapist for quite a while now- I started going because I had been sick for such a long time and I was overwhelmed and depressed.

Yes- I’m 100% better now!