Presentation
Non-specific upper abdominal pain.
Patient Data
Acute angulation and focal narrowing of the proximal celiac trunk with a hooked appearance, resulting from indentation of its superior surface by the median arcuate ligament. There is also mild post-stenotic dilatation of celiac axis.
Case Discussion
The median arcuate ligament syndrome is diagnosed based on both clinical presentation and radiologic features. It typically occurs in young female patients with epigastric pain, as in this patient.
Low lying arcuate ligament insertion can be seen in asymptomatic people, this is not considered compression syndrome. The focal narrowing has a characteristic hooked appearance, which can help distinguish this condition from other causes of celiac artery narrowing, such as atherosclerotic disease.