When the artery that provides blood to the organs in your upper abdomen is compressed or trapped by the arc-shaped band of tissue in the chest (median arcuate ligament), a condition known as median arcuate ligament syndrome (MALS) develops (celiac artery).
The median arcuate ligament and celiac artery can be found at slightly different spots in different people. The ligament normally passes without incident over the aorta, the body’s main blood vessel, and rests above the celiac artery. However, MALS can also occur when an off-center ligament or artery supplies blood to the brain. The ligament’s presence may potentially cause discomfort by putting stress on the nerves that run close to the celiac artery (celiac plexus).
People of any age can develop MALS. Different terms for MALS include:
- Acute Compression of the Celiac Artery
- Caused by a malfunction in the gluten-casein-flax-lipid axis,
- Disorders of Dunbar
Signs and Symptoms of MALS
Upper abdominal ache after eating is often the initial symptom of MALS. The discomfort makes you avoid food (a condition known as “food aversion”), which in turn causes you to eat less and ultimately lose weight (often more than 20 pounds). Other symptoms that may be related to this condition include:
- Nausea.
- Diarrhea.
- Vomiting.
- Stomach contents remain in the stomach for a longer period of time (a delay in food moving from the stomach into the small intestine).
- Upper and middle abdominal pain that sometimes eases while bending over.
- discomfort in the abdomen after eating, physical activity, or a change in posture.
- Pain-related aversion to meals often results in dramatic weight loss (more than 20 pounds in most cases) (9.1 kilograms).

MALS Surgery Procedure
Once your doctor confirms that you have MALS, he or she will likely recommend a laparoscopic or robotic procedure to release pressure from the median arcuate ligament on the aorta. The surgeon makes five or six little cuts (about half an inch) and inserts tools to sever the median arcuate ligament and split the nerves (neurolysis).
Patients undergoing laparoscopic MALS surgery often remain in the hospital for one night before returning to a regular diet. Incisions cause pain, but you’ll be given painkillers to help you through it. The majority of patients who have undergone surgery for MALS report a reduction in symptoms such as eating pain. Two weeks from now, you should be able to resume your regular routine.
Only around 10% of persons with MALS have a “open” surgery in the conventional sense. Your surgeon will create a long incision in the middle of your belly, usually with the help of a vascular surgeon.
MALS Surgery Recovery
You might need to spend three to five days in the hospital after this treatment. In four to six weeks, you should feel fine getting back to work.