Median arcuate ligament syndrome (MALS) is a rare condition in which the median arcuate ligament presses too tightly on an artery known as the celiac artery and the associated nerves. The median arcuate ligament is a band of tissue present in the lower part of the chest that normally passes over the aorta, or main artery, connecting the diaphragm to the spine. In MALS, the median arcuate ligament constricts the celiac artery, which supplies blood to the stomach, liver, and other digestive organs. MALS is most often seen in thin, young women. Symptoms and signs include pain in the upper abdomen after eating, avoidance of eating or food aversion, nausea, diarrhea, vomiting, and delayed emptying of the stomach. Median arcuate ligament syndrome is sometimes referred to as MALS disease.
Jameson, J. Larry, et al. Harrison's Principles of Internal Medicine, 20th Ed. New York: McGraw-Hill Education, 2018.