Causes
As the median arcuate ligament, a fibrous band of the diaphragm, compresses the celiac artery, it causes Median Arcuate Ligament Syndrome (MALS). There are several symptoms that can result from this compression of the stomach, liver, and other digestive organs. It is not always clear what causes MALS, but it is believed to be caused by anatomical variation in the position of the ligament and artery.
Symptoms
MALS symptoms can vary, but commonly include:
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Pain in the upper abdomen, often worse after eating.
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Fear of eating leads to unintentional weight loss and malnutrition.
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Vomiting and nausea: Frequent episodes of nausea and vomiting.
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A feeling of fullness or bloating in the abdomen.
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There is a possibility of occasional diarrhea.
Diagnosis
Clinical evaluation and imaging studies are used to diagnose MALS:
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An in-depth medical history and physical examination are required to identify characteristic symptoms.
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A Doppler ultrasound is used to assess blood flow through the celiac artery and detect narrowing or compression.
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Advanced imaging techniques to visualize the anatomy of the celiac artery and the median arcuate ligament, such as CT angiography or MRI.
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Injection of anesthetic near the celiac artery to see if it relieves symptoms, which can help confirm the diagnosis.
Treatment
MALS is typically treated with the following options:
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In order to alleviate the compression of the celiac artery, the median arcuate ligament is usually released surgically.
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An operation to cut the ligament and restore normal blood flow is called laparoscopic surgery.
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For more extensive decompressions, open surgery may be necessary.
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Medications used to manage chronic pain prior to surgery or for those who are not candidates for surgery.
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Weight loss and malnutrition can be addressed with diet modification and nutritional support.
Prevention
As MALS is an anatomical condition, there are no specific prevention measures, but early detection and treatment can reduce complications.
Conclusion
A rare condition known as Median Arcuate Ligament Syndrome occurs when the median arcuate ligament compresses the celiac artery, causing various gastrointestinal symptoms. Medical history, physical examination, and imaging studies are used to diagnose this condition. Surgery is the primary treatment to alleviate the artery's compression and restore normal blood flow. For individuals with MALS, early detection and treatment are crucial to managing symptoms and improving quality of life.
