Arcs of Buhler and Riolan
Thoracic back pain. ?aortic dissection.
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No evidence of aortic dissection.
High-grade stenoses of the origins of the celiac trunk and superior mesenteric arteries. There is a large anastomic vessel arising from the inferior mesenteric artery, traveling superiorly to communicate with the superior mesenteric artery (Arc of Riolan).
There is a tangle of vessels between the superior mesenteric artery and celiac trunk, appearing to communicate with both vessels (Arc of Buhler).
High grade stenoses of the celiac trunk and superior mesenteric artery have resulted in the development of enlarged collateral pathways between the IMA and SMA (Arc of Riolan), and the SMA and celiac trunk (Arc of Buhler).