What is MALS?

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Median Arcuate Ligament Syndrome

MALS is a congenital anatomical anomaly that occurs when the diaphragm is located too low in the body. This causes the median arcuate ligament to compress the celiac artery and the nerves of the celiac plexus.

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Symptoms and Diagnosis

Though MALS is not a gastrointestinal disorder, it presents with many gastrointestinal symptoms including pain after eating, nausea and/or vomiting, constipation and/or diarrhea, and unexplained weight loss. These symptoms can make MALS difficult to diagnose, as doctors will often search for a gastrointestinal cause. However, MALS often comes with other symptoms unrelated to the gastrointestinal system, including fatigue, exercise intolerance, and positional discomfort. MALS is often diagnosed using an abdominal CT with contrast or a doppler mesenteric ultrasound--however, it is imperative in both cases that the doctors and technicians performing the tests and reading the results are knowledgable about MALS, otherwise the diagnosis may still be missed.

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Treatment

After diagnosis, patients may begin researching various surgical treatments, including open or laparoscopic surgeries. It is important to ask your potential surgeon how many MALS surgeries they've done, their success rate, and how they define success. Each surgeon performs a MALS operation differently, so thorough research on the part of patients and caregivers is necessary to find the technique that's right for you.