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Median Arcuate Ligament Syndrome rare but vomiting, pain common symptoms: Bangalore doctor

Dr. JS Rajkumar, Founder of Lifeline Group of Hospitals speaks on rare disease MALS.

NEW DELHI: A Bangalore-based doctor has advocated for more attention on Median Arcuate Ligament Syndrome (MALS) as he has stressed that this disease affects only 1 in 20,000 people. Dr. JS Rajkumar, Founder of Lifeline Group of Hospitals, while speaking to The New Indian, said, “It is a very rare disease, affecting only one in 20,000 young people.

A 2020 report in the Journal of Vascular Surgery also sheds light on the complexities surrounding MALS.

It says that this condition arises from the compression of the celiac artery by the median arcuate ligament, leading to a range of symptoms associated with foregut ischemia, including abdominal pain, nausea, vomiting, and weight loss.

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Despite its significant impact on affected individuals, MALS remains with a delayed diagnosis due to its poorly understood pathophysiology, variable symptom severity, and unpredictable response to treatment.”

 

Difference between a normal diaphragm and one with Median Arcuate Ligament Syndrome (MALS)

 

MALS has no consensus on diagnostic criteria exists. Various methods, including duplex ultrasound, angiography, and gastric exercise tonometry, are used with varying degrees of effectiveness. 

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Surgical decompression of the MAL, performed through robotic, laparoscopic, endoscopic, or open techniques, is the primary treatment, offering symptom relief in many cases.

Dr. Rajkumar added that MALS can be diagnosed through focused tests, individuals experience abdominal pain and vomiting immediately after eating, which prevents them from consuming food, leading to massive weight loss, in severe cases, the condition can be fatal. 

He further suggests that in this condition the ligament blocks the blood vessels, robotic surgery is the latest method for a successful procedure.

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