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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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Kari Ulrich, Alumna Mentor | @kariulrich | May 21, 2018
In reply to @grandmajo "I was told to come back in 6 moths for Doppler imaging. I was given med..." + (show)
Profile picture for grandmajo @grandmajo

I was told to come back in 6 moths for Doppler imaging. I was given med for cholesterol and advised to take 1 aspirin every day. When I asked what should I expect or look for unti this is resolved, he answered, "Just be aware".......OMG, aware of what?
So I will have all my records and scans sent to Mayo to see if they can help. I have read that they will do something because there is a pretty good chance of getting a blood clot in small intestine if arteries remain blocked.
I'll keep you updated as I look for a solution.

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Yes, Please keep us updated. I hope you find some help, in the meantime if you have pain that worsens, or any other symptoms that develop please do not hesitate to go to the ER. I know we question our symptoms often and go back and forth if we should be seen, but rather error on the side of caution when it comes to any kind of ischemia! Thinking of you!

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Ingegerd Enscoe, Alumni Mentor | @astaingegerdm | May 21, 2018
In reply to @astaingegerdm "I was always worse sitting bent over. Lying down best for me." + (show)
Profile picture for Ingegerd Enscoe, Alumni Mentor @astaingegerdm

I was always worse sitting bent over. Lying down best for me.

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I would flip flop!! Moving things around after a meal.

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grandmajo | @grandmajo | May 21, 2018

I was told to come back in 6 moths for Doppler imaging. I was given med for cholesterol and advised to take 1 aspirin every day. When I asked what should I expect or look for unti this is resolved, he answered, "Just be aware".......OMG, aware of what?
So I will have all my records and scans sent to Mayo to see if they can help. I have read that they will do something because there is a pretty good chance of getting a blood clot in small intestine if arteries remain blocked.
I'll keep you updated as I look for a solution.

REPLY
1 reply
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Kari Ulrich, Alumna Mentor | @kariulrich | May 21, 2018
In reply to @astaingegerdm "I was always worse sitting bent over. Lying down best for me." + (show)
Profile picture for Ingegerd Enscoe, Alumni Mentor @astaingegerdm

I was always worse sitting bent over. Lying down best for me.

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Does laying on one side versus the other make a difference? Do you lay flat? For me I lay on my left side. I know everyone's anatomy is a little different. This is an interesting discussion.

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Ingegerd Enscoe, Alumni Mentor | @astaingegerdm | May 21, 2018

I was always worse sitting bent over. Lying down best for me.

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4 replies
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beachbumgirl | @beachbumgirl | May 21, 2018

I had the CT scan with dye last week. The vessels were....clear. Very surprised! So I called my Gastro
Doctor. She wanted a Barium Swallow- to me the worst test in the world. It is in 1 week. She also looked at my scan to make sure from a MD standpoint it looked ok. I will follow-up with her
In June ( unless there is a cancellation)
Now , I’m glad it’s not my celiac artery.
Dr. Suess has his work set out for him.

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Kari Ulrich, Alumna Mentor | @kariulrich | May 21, 2018
In reply to @jjren "Has anyone noticed a difference with posture? Less pain leaning slightly forward versus sitting or standing..." + (show)
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Has anyone noticed a difference with posture? Less pain leaning slightly forward versus sitting or standing completely straight.

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Yes, definitely! I always sit with my legs pulled up to my chest.

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jjren | @jjren | May 21, 2018

Has anyone noticed a difference with posture? Less pain leaning slightly forward versus sitting or standing completely straight.

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1 reply
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beachbumgirl | @beachbumgirl | May 14, 2018

Pain and nausea are bad. Not taking anything for pain. Tomorrow I’m having a CT scan followed by a Vascular Surgeon appt.

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Kari Ulrich, Alumna Mentor | @kariulrich | May 14, 2018
In reply to @beachbumgirl "Hi. I’m new here. I had Celiac Artery Decompression in 9/2016. It started as epigastric pain..." + (show)
Profile picture for beachbumgirl @beachbumgirl

Hi. I’m new here. I had Celiac Artery Decompression in 9/2016. It started as epigastric pain after a Nissen Fundoplication 1/2016. I lost 76 lbs I was hospitalized many times. One time I met a wonderful surgeon who ordered testing of my celiac artery. Low and behold, that was the problem. This surgeon is VERY THOROUGH!
He needed to do a Endoscopy on me first to look at my Nissen. Once that was done in August, e planned the Laparoscopy Celiac Artery decompression. He rarely does open ones. In my case, he needed to take apart my Nissen to do the decompression then restructure the Nissen. This surgeon even CALLED ME THE NIGHT BEFORE THE SURGERY! I was amazed. The surgery went well. I stayed overnight. I was discharged the next day. His diet protocols were slow and steady. It took me 3 months to feel better and gain weight. The surgeon
was just on the cusp of starting a feeding tube. He saw me routinely until I felt better and was gaining weight.
About 1 month ago, the symptoms returned. I called the previous surgeons office, left a message as to how to proceed. He the proceeded to call me back that afternoon to discuss what I should do next. He is awesome!
So I’m following up with the Vascular Team tomorrow. Day by day the epigastric Pain worsens, nausea and dry heaves worsens, any activity like walking gives me more nausea and pain. The next step is a stent I was told by vascular. It is an awful condition.
Interesting enough, my younger sister has MALS also but in a different artery.

Wishing all here less pain..

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Thank you for sharing your experience! You have been through a lot. It sounds like your surgeon is on top of this, please keep us up-to-date on what your next step is. So many of us do well, and unfortunately the pain returns. Welcome to Mayo Connect, it is so helpful to others to hear each person's experience. What are you doing to control the pain currently?

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