Median arcuate ligament syndrome (MALS), also known as celiac artery compression syndrome, is a rare condition characterized by compression of the celiac artery and nearby nerves by the median arcuate ligament (MAL), a fibrous band of tissue that connects the diaphragm to the spine. This compression can lead to symptoms such as abdominal pain, nausea, and weight loss, particularly after eating.
Key points:
-
Symptoms: Chronic postprandial (after eating) abdominal pain. Other symptoms may include nausea, vomiting, diarrhea, unintentional weight loss, and an audible bruit (abnormal sound) over the abdomen.
-
Diagnosis: Use a combination of medical history, physical examination, imaging studies (such as CT angiography or duplex ultrasound), and sometimes diagnostic injections to confirm the compression of the celiac artery.
-
Treatment: Relieve the compression of the celiac artery and alleviate symptoms. Conservative management includes dietary modifications, pain management, and lifestyle changes. For severe symptoms, surgery can divide the median arcuate ligament to release the compression on the celiac artery, known as median arcuate ligament release.
-
Prognosis: Many individuals experience significant improvement or resolution of symptoms following surgical intervention.
-
Complications: If left untreated, MALS can lead to complications such as malnutrition due to poor dietary intake and chronic pain that affects quality of life.
-
Differential Diagnosis: MALS should be distinguished from other causes of abdominal pain, such as gastritis, peptic ulcer disease, pancreatitis, or other vascular disorders.