what is mals

Median arcuate ligament syndrome (MALS) is a rare medical condition characterized by abdominal pain attributed to compression of the celiac artery and the celiac ganglia by the median arcuate ligament. The median arcuate ligament is a band of tissue in the abdomen that arches over the aorta and can press too tightly on the celiac artery and the nerves in the area, causing pain. Symptoms of MALS include abdominal pain, particularly in the epigastrium, which may be associated with eating and which may result in anorexia and weight loss. The pain can be in the left or right side, but usually where the ribs meet. Other signs are persistent nausea, lassitude (especially after a heavy meal) and exercise intolerance. Diarrhea is a common symptom, some experience constipation. While some experience vomiting, not everyone does. The diagnosis of MALS relies on a combination of clinical features and findings on medical imaging. Clinical features include those signs and symptoms mentioned above; classically, MALS involves a triad of symptoms: postprandial abdominal pain, weight loss, and an abdominal bruit. Imaging studies such as ultrasound, CT scan, or MRI can help confirm the diagnosis. Surgery is the only treatment option for MALS. The most common procedure is called median arcuate ligament release, or median arcuate ligament decompression. Its usually done as an open surgery. Sometimes it can be done as a minimally invasive (laparoscopic or robotic) procedure.