Diseases and Conditions

Median arcuate ligament syndrome (MALS)

Treatment

Surgery is the only treatment option for MALS. The most common procedure is called median arcuate ligament release, or median arcuate ligament decompression. It's usually done as an open surgery but sometimes can be done as a minimally invasive (laparoscopic or robotic) procedure.

While you're under general anesthesia, a surgeon divides the median arcuate ligament and network of nerves in the stomach area (celiac plexus). Doing so provides more room for the artery, restores blood flow and relieves pressure on the nerves.

Some people with MALS may need an open surgery to repair or replace a blocked celiac artery and fully restore blood flow (revascularization).

If you have MALS release surgery, you'll usually stay in the hospital for two to three days. You'll need an ultrasound about a month after surgery to confirm that blood flow through the celiac artery is fully restored. Several studies have shown that surgery to release the median arcuate ligament is safe, even in children with MALS. It often results in immediate pain relief and improves the person's quality of life.