Median Arcuate Ligament Syndrome | Orlando surgeon explains signs, symptoms and treatment
Orlando Health surgeon Dr. Joseph Ibrahim and lifelong performer Tayler Tennant raise awareness of a rare condition called MALS, or median arcuate ligament syndrome
AS THE MONTH OF FEBRUARY COMES TO A CLOSE, IT BRINGS AWARENESS THAT’S AHEAD. ON SATURDAY, FEBRUARY 28TH. IN THIS STORY, YOU HEAR HOW A RARE DISEASE BROUGHT PAIN AND SUFFERING TO A WOMAN. BUT NOW SHE IS SLOWLY GETTING HER LIFE BACK. PERFORMER TAYLOR TENNANT BY THE BEACH, LIVING HER BEST LIFE. I WENT FROM PERFORMING AND BEING ABLE TO DO STUFF AT FULL CAPACITY, TO SLOWLY HAVING TO BREAK DOWN. IT WENT FROM 100% TO 50% VERY QUICKLY, AND THEN FROM 50% TO 10%, AND THEN FINALLY I HIT 0% AND I KNEW I COULDN’T DO IT ANYMORE. TAYLOR WAS IN PAIN. SHE WAS DIAGNOSED WITH MEDIAN ARCUATE LIGAMENT SYNDROME, ALSO KNOWN AS MALS. MY CELIAC ARTERY WAS BEING COMPRESSED BY MY DIAPHRAGM. BASICALLY MEANING THAT IT WAS CUTTING BLOOD FLOW OFF TO MY LIVER, TO MY SPLEEN, TO MY STOMACH. THE MOST IMPORTANT ORGANS. TAYLOR KNEW THE ONLY WAY TO GET BACK TO THE STAGE AND OUT OF A HOSPITAL BED WAS SURGERY. THE SYMPTOMS INVOLVE PEOPLE HAVING PAIN, NAUSEA, VOMITING, OFTENTIMES AFTER MEALS TO THE POINT WHERE THEY HAVE A FEAR OF EATING. ORLANDO HEALTH SURGEON, DOCTOR JOSEPH IBRAHIM, EXPLAINS WHY MALS IS SO RARE AND IS LIFE CHANGING. IT CAN IMPACT PEOPLE’S LIVES BY THE FACT THAT THEY CAN’T EAT. THEREFORE, THEY’RE OFTENTIMES MALNOURISHED. THEY’RE UNDER OR DEHYDRATED, SO THEN THEY CAN’T REALLY FUNCTION IN A NORMAL CAPACITY WHEN IT COMES TO WORK, WHEN IT COMES TO PLAY, WHEN IT COMES TO JUST DOING NORMAL ACTIVITIES OF DAILY LIFE, A LOT OF THESE INDIVIDUALS REALLY BECOME ALMOST BEDBOUND, OR AT LEAST HOMEBOUND. TAYLOR IS COMING UP ON TWO YEARS SINCE HER SURGERY AND IS HOPEFUL SHE WILL PERFORM AGAIN ONE DAY. HE SAVED MY ENTIRE LIFE WITH ONE SIMPLE SURGERY. I FEEL LIKE A HUMAN BEING AGAIN AND NOT. HOWEVER, I FELT SO BROKEN FOR FOUR YEARS AND NOW I’M. I FEEL COMPLETE. TO SEE THEM THRIVING. AND AGAIN, SHE’S JUST ONE OF SEVERAL. FORTUNATELY WE’VE HAD YOU KNOW, AS WE MENTIONED, PEOPLE COMING BACK. HOW LONG DO YOU THINK I’VE HAD THIS? I HAVEN’T FELT THIS GOOD SINCE. I CAN’T REMEMBER WHEN. AND AGAIN, YOU CAN’T ASK FOR AS A PHYSICIAN. WELL, MARLEI IS SUCH A RARE CONDITION. ABOUT TWO OUT OF 100,000 PATIENTS ARE DIAGNOSED. AND JOINING US NOW IS ORLANDO HEALTH SURGEON, DOCTOR JOSEPH IBRAHIM. DOC, WELCOME. GOOD MORNING. THANKS FOR HAVING ME. SO HAPPY YOU’RE HERE TODAY. SO LET’S TALK ABOUT THIS. WONDERFUL TO SEE TAYLOR’S OUTCOME HERE, HER RECOVERY. BUT WHAT DO YOU WANT PEOPLE TO KNOW ABOUT THIS RARE DISEASE. SO YOU KNOW, THE BIGGEST THING FOR MY EXPERIENCE WITH THIS IS THAT PEOPLE GET FRUSTRATED BECAUSE THEY KIND OF HIT A ROADBLOCK. THEY GET WORKED UP FOR SOME OF THE MORE COMMON CAUSES OF THEIR SYMPTOMS, AND THEN PEOPLE JUST DON’T KNOW WHERE TO GO. AND SO THEY HAVE TO KIND OF BE SELF-ADVOCATES FOR THIS PROBLEM AND ASK, HEY, IS IT POSSIBLE THAT I HAVE MEDIAN ARCUATE LIGAMENT SYNDROME OR MALS? OKAY, OKAY. SO SO LET’S TALK ABOUT THAT THEN. WHAT SHOULD THEY BE LOOKING FOR IF THEY THINK OKAY, SOMETHING’S OFF, BUT THEY’RE REALLY NOT GETTING THE ANSWERS THAT YOU KNOW THAT THEY WANT. RIGHT. SO THE MOST COMMON SYMPTOMS ARE PAIN AFTER EATING IN THE UPPER ABDOMINAL AREA TO THE POINT WHERE THEY’LL EVEN HAVE A FEAR OF EATING. THEY’LL ALTER THEIR EATING HABITS. THEY’LL LOSE SIGNIFICANT WEIGHT. AND IT CAN EVEN AS YOU HEARD FROM TAYLOR’S EXPERIENCE, IT GETS TO THE POINT WHERE IT AFFECTS YOUR SOCIAL LIFE. IT CAN AFFECT YOUR FAMILY LIFE. YOU EVEN START TO DOUBT, AM I IMAGINING THIS OR DO I? DO I REALLY HAVE A PROBLEM OR IS THERE SOMETHING ELSE WRONG WITH ME? WELL, IT SOUNDS LIKE TO A LOT OF THESE, THESE FOLKS THAT HAVE THAT KIND OF THING. ABSOLUTELY. THEY GET SO DECONDITIONED, SO WEAK. THEY LOSE SO MUCH WEIGHT, WHICH THEN CAN THEN LEAD TO OTHER PROBLEMS AS WELL. SO HOW DO YOU DIAGNOSE IT THEN? SO THE GOOD THING NOW IS, YOU KNOW, IT’S RELATIVELY EASY TO DIAGNOSE. YOU KNOW, SOME IMAGING STUDIES SUCH AS A CT SCAN OR AN X RAY STUDY WHERE WE LOOK AT THE BLOOD VESSELS IN THE ABDOMEN. IT’S NONINVASIVE STUDY. THEN WE CAN DO AN ULTRASOUND TO LOOK AT WHAT THE BLOOD FLOW LOOKS LIKE. AND THEN LASTLY WE DO A PROCEDURE TO HOPEFULLY GIVE THEM SOME RELIEF, BUT ALSO TELLS US IF IF THEY WOULD BENEFIT FROM SURGERY. AND THAT’S A NERVE BLOCK TO SHOW THAT THEY GET RELIEF WITH THIS NERVE BLOCK, THEY WOULD BENEFIT FROM THE SURGERY AS WELL. SO TAKE US THROUGH THE SURGICAL PROCESS. THAT IS THE ONLY TREATMENT, RIGHT? UNFORTUNATELY, THAT IS THE ONLY ONLY TREATMENT FOR THIS RIGHT NOW. SO LUCKILY WE CAN DO THIS WITH VERY SMALL INCISIONS AND A CAMERA. IT’S CALLED LAPAROSCOPIC SURGERY. WE ORLANDO HEALTH DO USE THE ROBOTIC SYSTEM FOR THIS. IT TAKES 4 TO 5 SMALL INCISIONS ON THE ABDOMEN, AND WE ACTUALLY FREE UP THE COMPRESSION OF THE BLOOD VESSEL, WHICH IS TYPICALLY FROM THE DIAPHRAGM, WHICH IS THE MUSCLE THAT HELPS US BREATHE. SO DOC, JUST SEEING HER STORY AND SEEING HOW SHE’S DOING SO MUCH BETTER NOW AFTER BEING IN PAIN FOR FOUR YEARS, WHAT’S THAT LIKE FOR YOU? THAT’S THE ULTIMATE GOAL, RIGHT? ABSOLUTELY. IT’S THE BIGGEST GRATIFICATION FOR A PHYSICIAN, YOU KNOW, TO SEE HER. AND AS YOU HEARD ME SAY, WE’VE GOT SO MANY MORE THAT THEIR LIVES ARE ALTERED. I HAD A POLICE OFFICER WHO CAME ALL THE WAY FROM LAS VEGAS TO SEEK TREATMENT, AND SHE COULDN’T DO HER PHYSICAL TRAINING TO MAINTAIN HER JOB AS A POLICE OFFICER. CAME HERE IMMEDIATELY, GOT RESULTS, WAS BACK ON THE JOB IN TWO WEEKS AFTER. SO IT REALLY IS SO GRATIFYING TO SEE THEM GET THEIR LIVES BACK. THAT’S THE ULTIMATE GOAL AND THAT SAYS A LOT. SO YOU HAVE PEOPLE COMING FROM VEGAS THINKING THAT YOU GUYS ARE RENOWNED. THIS IS THE PROGRAM TO TO COME TO. CORRECT. EXACTLY. WE’RE TRYING TO GET THE WORD OUT. THAT’S PART OF THE PROBLEM. WE FEEL LIKE WE STILL HAVEN’T DONE A GREAT JOB AT GETTING THE WORD OUT THAT WE CAN TAKE CARE OF THIS, AND THERE AREN’T VERY MANY PROGRAMS IN THE COUNTRY THAT DO THIS. SO IT’S NOT ME. IT’S A WHOLE SYSTEM. THERE’S THE VASCULAR SURGEONS, THE RADIOLOGISTS. IT’S A WHOLE TEAM THAT WE HAVE THAT HELPS TREAT THIS PROCESS. WE’LL TALK. THANKS S
Median Arcuate Ligament Syndrome | Orlando surgeon explains signs, symptoms and treatment
Orlando Health surgeon Dr. Joseph Ibrahim and lifelong performer Tayler Tennant raise awareness of a rare condition called MALS, or median arcuate ligament syndrome
Updated: 10:03 AM EST Feb 20, 2026
February is Median Arcuate Ligament Syndrome, or “MALS” Awareness Month.To raise awareness, Orlando Health surgeon Dr. Joseph Ibrahim and lifelong performer Tayler Tennant detail four years of what she describes as a “carousel of pain” due to MALS, a rare condition.MALS occurs when a ligament in the diaphragm presses on one of the main arteries that sends blood to the spleen, stomach and liver. The main symptoms include excruciating abdomen pain, nausea and vomiting. An estimated two out of 100,000 patients have MALS, according to a Journal of Vascular Surgery publication. As an actress, dancer and singer, Tennant says MALS played a major role in her having to step away from the stage. Now, she will soon be celebrating two years since her MALS surgery and journey toward a full recovery. Click here to learn more.
ORLANDO, Fla. —
February is Median Arcuate Ligament Syndrome, or “MALS” Awareness Month.
To raise awareness, Orlando Health surgeon Dr. Joseph Ibrahim and lifelong performer Tayler Tennant detail four years of what she describes as a “carousel of pain” due to MALS, a rare condition.
MALS occurs when a ligament in the diaphragm presses on one of the main arteries that sends blood to the spleen, stomach and liver.
The main symptoms include excruciating abdomen pain, nausea and vomiting.
An estimated two out of 100,000 patients have MALS, according to a Journal of Vascular Surgery publication.
As an actress, dancer and singer, Tennant says MALS played a major role in her having to step away from the stage.
Now, she will soon be celebrating two years since her MALS surgery and journey toward a full recovery.