New Approach Offers Hope for Sufferers of Rare Condition in UAE

Patients with Median Arcuate Ligament Syndrome Often Wait Years for Correct Diagnosis

Physicians at Cleveland Clinic Abu Dhabi are bringing a new, minimally invasive surgical procedure to the Middle East to treat a poorly understood, yet often debilitating, condition that largely affects young women. 

Median Arcuate Ligament Syndrome (MALS) is a rare condition most common in young, otherwise healthy, women between the ages of 15 and 40.

The condition has a range of symptoms, including severe abdominal pain, nausea, vomiting, diarrhea and delayed emptying of the stomach, which are often made worse by physical activity or eating. It is caused by the median arcuate ligament pressing on the celiac artery and the nerves surrounding it.

Diagnosing and treating the syndrome requires expertise from two distinct medical fields – vascular medicine and digestive disease. Building on Cleveland Clinic Abu Dhabi’s multidisciplinary approach, physicians at the hospital have worked together to establish a MALS program, an extension of its successful program at Cleveland Clinic in the US. 

“Because the symptoms of MALS are so closely linked to the digestive system, if a patient presents with abdominal pain that isn’t gastrointestinal it can be difficult to diagnose without an expert approach,” says Dr. Matthew Kroh, Chair of the Digestive Disease Institute at Cleveland Clinic Abu Dhabi. “This has left many patients searching for years for the correct diagnosis.” 

“The tragedy of this condition is that it is not well understood by the general medical community. The symptoms are frequently-occurring enough that they overlap with other, more common conditions. Based on our experience in the United States, it takes patients an average of two years before they find a doctor who can diagnose MALS. It can take even longer in the MENA region, where there is less awareness of the condition,” says Dr. Woosup Park, Chair of Vascular Surgery at Cleveland Clinic Abu Dhabi’s Heart & Vascular Institute.

Once diagnosed with MALS, most patients require surgery to relieve the pressure on the celiac artery. Following the surgery, patients usually find that their symptoms are significantly reduced or eliminated. Traditionally, this has meant a full, open surgery that puts patients at higher risk of complications. Dr. Kroh and Dr. Park have developed a minimally invasive, laparoscopic approach that enables patients to go home the day after their operation. 

Cleveland Clinic Abu Dhabi deploys a multidisciplinary team approach for the evaluation and treatment of MALS. This collaboration and combined institutional experience enhances the safety and outcomes of patients with this relatively rare but debilitating disease. 

Patients who are interested in booking an appointment to discuss treatments can contact 800 8 CCAD (800 8 2223) or visit www.clevelandclinicabudhabi.ae.