MEDIAN ARCUATE LIGAMENT SYNDROME (MALS) OR DUNBAR SYNDROME

This condition consists in the compression of the celiac trunk by the median arcuate ligament.

The celiac trunk is a branch of the abdominal aorta that supplies irrigation to the abdominal foregut derivatives.

The median arcuate ligament is the central band of fibrous tissue that connects the right and left crura of the diaphragm.

In a patient with MALS, the median arcuate ligament compresses the celiac trunk, preventing the correct blood supply to the abdominal organs and impairing their proper function.

imagen diafragma
tronco celiaco

  • There is a neurogenic variant of the median arcuate ligament syndrome (nMALS), where the median arcuate ligament compresses or irritates the nerves surrounding the solar plexus – also called the celiac plexus -.

  • The solar (celiac) plexus is a network of nerves composed of several nerve fibers and ganglia that connect with multiple organs in the abdominal cavity. This structure surrounds the abdominal aorta, the celiac trunk and the superior mesenteric artery.

  • The solar plexus is involved in the transmission of nociceptive information, i.e., the sensation of pain. This aspect makes the neurogenic variant very painful and disabling.

imagen aorta

In patients with a severe neurogenic variant, it can cause widespread contractures throughout the body. Moreover, when there is a significant nerve involvement, peripheral sensory neuropathy and/or hyperalgesia can be triggered, making movement difficult or impossible due to the intense and disabling pain.

imagen variante neurogénica

Frequent symptoms

  • Nausea

    Vomiting

  • Reflux

    Belching

  • Heavy and painful digestions

    Weight loss

  • Pain in the area near the heart

    Chest pressure

  • Shortness of breath

    Dizziness

  • Sweating

    Tachycardia

  • Fainting

    Síncopes

  • Pain in the diaphragmatic area

    Chest and epigastric pain

  • Neuropathic pain

    Blurred vision

  • Vertigo

    Tendency to collapse