Celiac artery compression by the diaphragmatic crurae

Case contributed by Bruno Di Muzio
Diagnosis almost certain

Presentation

CT scan to evaluate aortic aneurysm.

Patient Data

Age: 67
Gender: Male

CTA Abdominal aorta

ct

CT scan demonstrates a fusiform aortic aneurysm. There is also a compression of the celiac trunk by the diaphragmatic crurae.

Arrows show a compression of the celiac trunk by the diaphragmatic crurae. The compression is overestimated on 3D reformatation. 

Case Discussion

The median arcuate ligament is the fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. In some people, this ligament has a low insertion point and may compress the celiac trunk. 

As in this case, the finding is commonly asymptomatic. However, it may cause ischemic-type epigastric pain, which determines the syndrome called: Celiac artery compression syndrome, also known as celiac axis syndrome, median arcuate ligament syndrome and Dunbar syndrome

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