Median Arcuate Ligament Syndrome (MALS)

Yes, unfortunately it can recompress. A number of things can happen, depending on what the surgeon did and didn't do, and your specific case. In my case, scar tissue formed around the artery, so I had the same pattern of compression on ultrasound as shown prior to surgery. When I was operated on a 2nd time, the surgeon also found a mass of neural tissue compressing the celiac trunk, which she removed, and divided the ligament an additional 2 cm apart. My first surgeon probably just didn't do enough. Overall I am doing better after this 2nd surgery but I worry constantly about it coming back with every twinge of pain.

Another issue that I have heard about is the artery can fail after years of compression, which would require a stent or bypass. Others on this forum can tell you more about that.

Hello. I am new to Mayo Connect. Back when I had my MALS surgery there was not much known about it. I am happy to see this group. I have been trying to contact my doctor in Rochester with no luck to get some answers. It has been about ten years since my surgery and I am having symptoms again. The syndrome was new back then so I wasn't told a lot about what to expect in the future. I am wondering if my artery can recompress again? Any info would be helpful.

How often did you have to go to your follow ups?

Congratulations ❤️❤️ I’m so happy for you! You have given me hope and have encouraged me. I also had unsuccessful compression surgery at a different hospital and I am eagerly awaiting news from Mayo that they will be able to insert a stent. God bless you and your wife (and my husband for putting up with me)!

Good news also with my situation, after a week staying off ibuprofen and using diclofenac topical, and taking 40 mg of Pepcid my stomach upset in the morning has finally gone away -- hopefully for good. I've had 2 mornings in a row without waking up sick.

As for the chest pains, @astaingegerdm is probably right that it's my diaphragm, because deep breathing also triggers the tingling pain. I've been doing a lot of stretching, 3 times a day. I think this is critical, and everyone who's had this surgery ought to see a physical therapist when they are ready. The reason is all the scar tissue inside the abdomen. I got a copy of my operative report and since this was my 2nd surgery, my surgeon had to work through a ton of adhesions just to get to my celiac trunk. Apparently there was a mass of neural tissue encasing the celiac origin that she removed, and the ligament also needed to be cut away much higher.

I still have a lot of worries, probably irrational ones, that it will come back yet again or something else will go wrong. I don't like the fact that I had so much scar tissue in me, but overall I'm in less pain at this point compared to where I was after the 1st surgery so that seems like a good sign. I've heard many people mention 3-4 months as the time frame to assess the surgery outcome, so until then I'm just going to keep stretching and hope this is the end of this miserable MALS saga.

It’s been a long road as a lot of you have being going through for years with a lot of naysayers out there! The fight is real and for those who have been dealing with this miserable syndrome! Keep fighting because there is light at the end of the tunnel!!! Don’t take a no for an answer, or it’s in your head because this is real! I must say you have to have a strong backbone along with support in getting to the resolution your wanting. To feel better and live a normal life. You have to keep plugging along.
The compression release and now the stent have definitely given my life back to me and for my family. I have two beautiful grandkids and I wasn’t going to sit around and waste away! I wanted to be able to run around and enjoy them!

If anyone has questions on who I used for doctors and etc. Please don’t hesitate in dropping a line.
Dr. Lowry was my General Surgeon that did my release. He’s out of Shawnee Mission Hospital & Providence Hospital. Very awesome doctor who listens and understands what your going through. Upfront and personal in your well-being.
Dr. Jenny Cho and Dr. DeCamp Vascular Surgeons. Both of them work together and put a plan together after my open procedure to release my ligament. I had laparoscopic that turned into open (zipper incision).
Both of them work for The University of Kansas Health System. Dr. DeCamp is just like Dr. Lowry down to earth and listens to all that you’re going through. With Dr. Cho and Dr. DeCamp both of them fixed what was broken. Again I’m grateful to all that helped me.