Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Vascular Surgery


Dr. Tom Colletti, DHSc, PA-C, DFAAPA


Median Arcuate Ligament Syndrome (MALS) is an anatomic variant in 10-20% of people. Symptoms are not typically present, but when they are, it can lead to interference with daily life. These symptoms include postprandial abdominal pain, fear of food, and significant weight loss. These symptoms are similar to that of chronic mesenteric ischemia, but lack the classic two mesenteric vessel characteristics of atherosclerotic disease. Treatment of MALS requires either open or laparoscopic surgical repair. There can be accompanying vascular compromise with MALS. This patient presented with a history of atherosclerotic disease and accompanying mesenteric bypass leading to a surprising finding of MALS.


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