Patient-Reported Experiences With Median Arcuate Ligament Syndrome: Resilience and Resources Required

• Published in: Clinical practice in pediatric psychology Vol. 10; no. 1; p. 44
• Main Authors: Stiles-Shields, Colleen, Osos, Sylwia, Sunnquist, Madison L, Mak, Grace Zee, Skelly, Christopher L, Drossos, Tina
• Format: Journal Article
• Language: English
• Published: United States 01.03.2022
• Subjects: median arcuate ligament syndrome; chronic abdominal pain; health disparities; patient experience; pediatric
• ISSN: 2169-4826
• DOI: 10.1037/cpp0000355

Median arcuate ligament syndrome (MALS) is a vascular condition that is treated surgically. MALS is a diagnosis of exclusion and therefore often requires that pediatric patients undergo an exhaustive number of tests and potential experiences with misdiagnosis before receiving an accurate diagnosis and treatment. The purpose of the current mixed-methods study was to assess the pediatric patient- and parent-reported experience of (a) coping with and managing symptoms associated with MALS and (b) the diagnostic, treatment, and recovery process for pediatric MALS. Nine postsurgical pediatric patients ( age = 20.11 ± 3.59; all <18 at time of surgery) and 6 parents participated in semistructured focus groups and completed self-report questionnaires about their experiences and current functioning. Four themes emerged: (a) the impact of MALS (physical and psychosocial), (b) uncertainties and feeling misunderstood, (c) extensive medical tests, and (d) mental health impacts, with an additional three themes related to specific querying (i.e., appreciation, recommendations, and interdisciplinary treatment team). With the exception of variable long-term physical impacts, patients and their parents reported fairly consistent experiences, and the content of these themes was consistent with self-reported quantitative data. The current study highlights the resilience and resources seemingly required for effective diagnosis and intervention for pediatric MALS. The need for increased knowledge about MALS, the inclusion of an interdisciplinary treatment team, and long-term follow-up for pediatric patients with MALS are implicated.