Median Arcuate Ligament Syndrome (MALS)

Overview

Median Arcuate Ligament Syndrome (MALS) is a rare condition that occurs when the median arcuate ligament (MAL) compresses the celiac artery, which is responsible for supplying blood to the upper abdomen. The compression can cause a range of symptoms, including stomach pain, abdominal pain, and digestive issues. In this article, we will explore the causes, symptoms, diagnosis, treatment, and management options for MALS.

The median arcuate ligament is a band of tissue located in the chest area that connects the diaphragm to the transverse processes of the lumbar vertebrae. The celiac artery is the main blood vessel that supplies oxygenated blood to the upper abdomen. In MALS, the MAL compresses the celiac artery, reducing blood flow to the upper abdomen and causing symptoms.

Types of Median Arcuate Ligament Syndrome (MALS)

There are two main types of MALS:

1. Primary MALS: This type of MALS occurs when the MAL is normal but compresses the celiac artery due to anatomical variations.
2. Secondary MALS: This type of MALS occurs when there is an abnormality in the MAL or surrounding structures that causes compression of the celiac artery.

Causes of Median Arcuate Ligament Syndrome (MALS)

The exact cause of MALS is not fully understood, but it is thought to be related to anatomical variations in the MAL and surrounding structures. Other factors that may contribute to the development of MALS include:

1. Genetic factors: Some people may be born with an anatomical variation in the MAL or surrounding structures that increases their risk of developing MALS.
2. Trauma: Trauma to the chest or abdomen can cause damage to the MAL or surrounding structures, leading to compression of the celiac artery.
3. Congenital conditions: Certain congenital conditions, such as diaphragmatic hernia or congenital heart disease, may increase the risk of developing MALS.

Risk Factors of Median Arcuate Ligament Syndrome (MALS)

The following risk factors may increase the risk of developing MALS:

1. Age: MALS is more common in people over 40 years old.
2. Sex: Women are more likely to develop MALS than men.
3. Family history: A family history of MALS may increase an individual's risk of developing the condition.
4. Obesity: Obesity may increase the risk of developing MALS due to increased pressure on the MAL and surrounding structures.

Symptoms of Median Arcuate Ligament Syndrome (MALS)

Preventions of Median Arcuate Ligament Syndrome (MALS)

There is no known way to prevent MALS, but early diagnosis and treatment can help manage symptoms and prevent complications.

Diagnosis of Median Arcuate Ligament Syndrome (MALS)

The diagnosis of MALS typically involves a combination of physical examination, imaging studies, and laparoscopic evaluation. The following diagnostic tests may be used:

1. Physical examination: A physical examination can help identify signs of compression on the celiac artery.
2. Imaging studies: Imaging studies such as computed tomography (CT) scans or magnetic resonance imaging (MRI) scans can help confirm the diagnosis and identify any anatomical abnormalities.
3. Laparoscopic evaluation: A laparoscopic evaluation can help identify any anatomical abnormalities and allow for surgical intervention.

Treatment for Median Arcuate Ligament Syndrome (MALS)

The treatment of MALS typically involves a combination of surgical intervention and conservative management. The following treatment options may be used:

1. Surgical intervention: Surgical intervention involves releasing the compression on the celiac artery by dissecting the MAL from surrounding structures.
2. Conservative management: Conservative management involves managing symptoms through lifestyle changes and medications.

When to seek medical attention ?

If you are experiencing persistent stomach pain or discomfort, it is essential to see a doctor for evaluation and treatment. A doctor can diagnose and treat MALS effectively if it is caught early.