Chronic RUQ pain

An update would probably be helpful, especially if these symptoms are commonly seen!

I ended up going to Cleveland Clinic in February and met with Dr. Abraham, an anesthesiologist/pain specialist and Dr. Park, a vascular surgeon. Dr. Abraham did a diagnostic celiac plexus nerve block and after a few hours I went for a hard run to try and induce the pain. No pain! Also had a CTA and doppler ultrasound done. Although the arterial velocity of my celiac artery was normal, the CTA showed a minor compression of my celiac artery, such that with the pressure of blood flow with my heart rate high during running, there would be enough pressure on the celiac plexus nerve to cause the pain I’m having.

So the diagnosis is a mild form of MALS, median arcuate ligament syndrome. My treatment options are surgery to release the ligament and sever the celiac plexus nerve or live with it. I’m choosing to live with it right now as the surgery for this is relatively new and failure rate too high for me to take the chance. Most patients with it have pain with eating and nausea which I do not, so pain with running I can handle.

Hopefully this helps others with similar pain!