Median Arcuate Ligament Syndrome (MALS) |Abdominal Pain | MedStar Health

A condition that reduces blood flow to the digestive system and causes severe abdominal pain

The celiac artery is a branch of the aorta that delivers blood to the stomach, liver, and other organs. When the celiac artery becomes pinched between the median arcuate ligament, which wraps around the aorta to connect the diaphragm and the spine, and the celiac plexus nerves around the aorta, it’s known as median arcuate ligament syndrome (MALS).

The reduced blood flow to the digestive system can cause:

  • Abdominal pain, often after eating

  • Nausea and vomiting

  • Pain-induced loss of appetite

  • Weight loss


Diagnosing median arcuate ligament syndrome is the first step to developing a treatment plan. Our specialists may recommend one or more diagnostic and imaging procedures.

Angiogram (Angiography)

An angiogram is a special X-ray taken as a special dye is injected through a thin, flexible tube called a catheter to detect blockages or aneurysms in blood vessels.

Cardiac Catheterization

Cardiac catheterization is a minimally invasive way to diagnose and treat a variety of heart and vascular conditions by guiding thin, flexible tubes called catheters through blood vessels to problem areas.

Computerized Tomography (CT) Scan

The cardiac computed tomography scan, or cardiac CT, uses X-rays to create three-dimensional images of your heart and blood vessels.


An echocardiogram uses high-frequency sound waves to create images of your heart.


Treatment for median arcuate ligament syndrome likely will require surgery to release the ligament to reduce the pressure on the celiac artery. The vascular surgeons in our Vascular and Endovascular Program offer the latest innovative and minimally invasive procedures to treat conditions such as median arcuate ligament syndrome.

Aortic Surgery

Aortic surgery describes a variety of procedures to treat conditions that affect the aorta.

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