1. < Digestive Health

Median Arcuate Ligament Syndrome (MALS)

Posted by Kari Ulrich, Alumna Mentor @kariulrich, Dec 26, 2016

I am looking for other patients that have been diagnosed with Median Arcuate Ligament Syndrome. Although it is caused by compression of the celiac artery many people experience abdominal pain after eating, diarrhea, food avoidance. Usually the first doctors they see are GI doctors. It is a diagnosis that is made after everything else is ruled out. I am curious if anyone else has had surgery?

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graceym1 | @graceym1 | Oct 12, 2024
In reply to @katiero123 "Can someone tell me what their mals pain was like? Mine is an intense gnawing in..." + (show)
@katiero123

Can someone tell me what their mals pain was like? Mine is an intense gnawing in my upper mid abdomen sometimes squeezing too. After eating. My velocities are over 400 and I have the hook on Ct scan.

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I have lower abdominal pain after eating. Feels like I’m going to burst. Also burning in chest! Hate it. Have you had celiac plexus block yet?

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1 reply
katiero123 | @katiero123 | Oct 10, 2024

Can someone tell me what their mals pain was like? Mine is an intense gnawing in my upper mid abdomen sometimes squeezing too. After eating. My velocities are over 400 and I have the hook on Ct scan.

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1 reply
graceym1 | @graceym1 | Aug 28, 2024
In reply to @mamabear80 "I suspect that my 15 year old daughter may have MALS. She has had constant abdominal..." + (show)
@mamabear80

I suspect that my 15 year old daughter may have MALS. She has had constant abdominal pain for 2 years that has just gotten worse. She spent a week in the hospital for severe abdominal pain and vomiting and had CT Abdomen, gastric emptying study, HIDA scan, endoscopy, abdominal ultrasound, and upper GI series that were all normal. They dx her with abdominal migraine, but the medicine they have her on has not made a difference. Her pain pattern also does not fit with abdominal migraine but seems to fit MALS perfectly. Her GI doctor does not seem to know how to help her. My question is how were you all diagnosed (what specific imaging did you have that showed MALS) and what type of specialist diagnosed you? Any insight is greatly appreciated.

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Hi. So sorry for you and your daughter. I had issues for over two years as well. It’s rough. I was diagnosed with cta of my stomach and a special ultrasound with breathing protocol done through vascular dept at uva hospital. Of my celiac artery as well as two other arteries. Good luck

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mamabear80 | @mamabear80 | Aug 27, 2024
In reply to @astaingegerdm "@mamabear80 The first test that suggested a vascular problem was an abdominal Doppler ultrasound. It was..." + (show)
@astaingegerdm

@mamabear80
The first test that suggested a vascular problem was an abdominal Doppler ultrasound. It was followed by a CT angiogram that confirmed celiac artery stenosis and MALS.
Gastroenterologist made the diagnosis and referred me to GI surgeon.

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Thank you!

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Ingegerd Enscoe, Alumni Mentor | @astaingegerdm | Aug 27, 2024

@mamabear80
The first test that suggested a vascular problem was an abdominal Doppler ultrasound. It was followed by a CT angiogram that confirmed celiac artery stenosis and MALS.
Gastroenterologist made the diagnosis and referred me to GI surgeon.

REPLY
1 reply
mamabear80 | @mamabear80 | Aug 27, 2024

I suspect that my 15 year old daughter may have MALS. She has had constant abdominal pain for 2 years that has just gotten worse. She spent a week in the hospital for severe abdominal pain and vomiting and had CT Abdomen, gastric emptying study, HIDA scan, endoscopy, abdominal ultrasound, and upper GI series that were all normal. They dx her with abdominal migraine, but the medicine they have her on has not made a difference. Her pain pattern also does not fit with abdominal migraine but seems to fit MALS perfectly. Her GI doctor does not seem to know how to help her. My question is how were you all diagnosed (what specific imaging did you have that showed MALS) and what type of specialist diagnosed you? Any insight is greatly appreciated.

REPLY
1 reply
ankit22784 | @ankit22784 | Jul 23, 2024
In reply to @astaingegerdm "@ankit22784 Welcome to Mayo Clinic Connect! Your symptoms could very well be signs of MALS. Not..." + (show)
@astaingegerdm

@ankit22784
Welcome to Mayo Clinic Connect!
Your symptoms could very well be signs of MALS. Not everyone has the same presentation.
In my case, I had surgery 2015 after many episodes of severe abdominal pain. The first test that hinted at the diagnosis was a Doppler ultrasound. The follow up test was a CT angiogram that confirmed the diagnosis.
2022 I had several abdominal symptoms that all were due to narrowing of the celiac artery- such as nausea, loss of appetite, getting full fast, pain a while after eating as well as weight loss. Tests showed that a stent that had been placed to keep artery open was kinked- like the artery. I had a new stent placed and all symptoms disappeared.
Try to get a doctor that is familiar with how to test correctly and who also has some experience with this condition.
I started with a gastroenterologist and the surgery where the ligament was cut was performed by a general surgeon.
My follow up visits were with a vascular surgeon.
Let us know what happens!

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@astaingegerdm Thank you for your inputs. Thats comforting to know that classic symptoms may not show but MALS can still interefere with our daily lives in a significant way

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ankit22784 | @ankit22784 | Jul 23, 2024
In reply to @graceym1 "I too have not all my symptoms are classic either. Mals pals is a great group..." + (show)
@graceym1

I too have not all my symptoms are classic either. Mals pals is a great group to join on face book. Lots of people have what we have. We try to share our stories and help each other. Have you had the celiac plexus block yet? That test pretty much determines if you’re a good candidate for the surgery.

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@graceym1 Thank you for your input. I will check for celiac plexus block. Your input was very helpful

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graceym1 | @graceym1 | Jul 23, 2024
In reply to @astaingegerdm "@ankit22784 Welcome to Mayo Clinic Connect! Your symptoms could very well be signs of MALS. Not..." + (show)
@astaingegerdm

@ankit22784
Welcome to Mayo Clinic Connect!
Your symptoms could very well be signs of MALS. Not everyone has the same presentation.
In my case, I had surgery 2015 after many episodes of severe abdominal pain. The first test that hinted at the diagnosis was a Doppler ultrasound. The follow up test was a CT angiogram that confirmed the diagnosis.
2022 I had several abdominal symptoms that all were due to narrowing of the celiac artery- such as nausea, loss of appetite, getting full fast, pain a while after eating as well as weight loss. Tests showed that a stent that had been placed to keep artery open was kinked- like the artery. I had a new stent placed and all symptoms disappeared.
Try to get a doctor that is familiar with how to test correctly and who also has some experience with this condition.
I started with a gastroenterologist and the surgery where the ligament was cut was performed by a general surgeon.
My follow up visits were with a vascular surgeon.
Let us know what happens!

Jump to this post

I too have some of the symptoms that you have. It’s not fun at all. But it gets better!

REPLY
graceym1 | @graceym1 | Jul 23, 2024
In reply to @ankit22784 "Hello everyone. My name is Ankit and I am from India. I was recently diagnosed by..." + (show)
@ankit22784

Hello everyone. My name is Ankit and I am from India.
I was recently diagnosed by MALS in CT scan test.
My symptoms are not classic MALS symptoms but as follows
1)Feel too full after eating/drinking very minimal food/liquid intake, 2) Feel very heavy/tightening/pulling inward in stomach after having food. 3) Feel weak/sluggish/difficulty walking and brain fog after having food/liquids. 4) Takes long hours of time to digest even very small quantity of food. 5) Lot of gas/flatuence happens after long hours of eating 6) Constipation. 7) Severe weight loss

Are my symptoms in line with MALS?

My doctors are not very sure, if we should go for surgery or not. Kindly help. Can laproscopic surgery help in my case. Request to please help

My doctors her

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I too have not all my symptoms are classic either. Mals pals is a great group to join on face book. Lots of people have what we have. We try to share our stories and help each other. Have you had the celiac plexus block yet? That test pretty much determines if you’re a good candidate for the surgery.

REPLY
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