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Median Arcuate Ligament Syndrome: A Rare Cause of Abdominal Pain with a Happy Ending
Median Arcuate Ligament Syndrome (MALS) is a rare condition that can cause abdominal pain, nausea, vomiting, and weight loss. It occurs when the median arcuate ligament, a fibrous band of tissue that crosses the front of the aorta, compresses the celiac artery. The celiac artery is responsible for supplying blood to the stomach, liver, spleen, and pancreas.
MALS is more common in young women, but it can affect people of all ages and genders. The exact cause of MALS is unknown, but it is thought to be related to the anatomy of the celiac artery and the median arcuate ligament.
Symptoms of MALS
The most common symptoms of MALS are:
Abdominal pain, especially after eating
Nausea and vomiting
Weight loss
Bloating and gas
Early satiety (feeling full quickly)
Back pain
Chest pain
Diagnosis of MALS
MALS can be difficult to diagnose because the symptoms are similar to other conditions, such as irritable bowel syndrome (IBS), peptic ulcer disease, and gallbladder disease. To diagnose MALS, doctors will typically perform a physical exam and ask about the patient’s medical history. They may also order tests such as an ultrasound, CT scan, or MRI to look for compression of the celiac artery.
Treatment of MALS
The only definitive treatment for MALS is surgery. During surgery, the surgeon will release the median arcuate ligament to relieve the compression on the celiac artery. Surgery can be performed laparoscopically or through an open incision.
In some cases, patients with MALS may be able to manage their symptoms with lifestyle changes, such as eating smaller meals more often and avoiding foods that are high in fat and fiber. Medications such as proton pump inhibitors may also be helpful.
If you think you may have MALS, it is important to see a doctor to get a diagnosis and treatment recommendations.
Median arcuate ligament syndrome
MALS
Celiac artery compression syndrome
Dunbar syndrome
Abdominal pain
Nausea and vomiting
Weight loss
Bloating and gas
Early satiety
Back pain
Chest pain
Rare disease
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Surgery
Lifestyle changes
Medications
Proton pump inhibitors
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Laparoscopic surgery
Open incision surgery
Minimally invasive surgery
Endovascular stenting
Angioplasty
Aortic dissection
Celiac artery aneurysm
Chronic mesenteric ischemia
Superior mesenteric artery syndrome
Nutcracker syndrome
Median arcuate ligament release
Celiac artery decompression
Aortic bypass surgery
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Embolization
Thrombolysis
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