Median arcuate ligament syndrome

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

History of recurrent abdominal pain, mainly periumbilical related to meals. Currently presenting with persistent abdominal pain since one day. Referred as ? appendicitis.

Patient Data

Age: 35
Gender: Female
CT

CT enterocolonography

The celiac trunk showed U-shaped stenotic configuration with post-stenotic dilatation as well as mildly dilated hepatic and splenic branches. Normal wall and enhancing features of bowel loops with no evidence of ischemic changes. The appendix is normal.

Case Discussion

In median arcuate ligament syndrome; the celiac trunk demonstrates a focal stenosis with characteristic hooked appearance due to the indentation on its superior surface. This appearance may be seen in normal people if imaging is acquired in expiration. So, the clinical history is mandatory to suggest such diagnosis. It usually presents in young age between 20 and 40 years. The young age of the patient and the characteristic hooked appearance distinguishes this syndrome from the main differential diagnosis of atherosclerotic disease.

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Case information

rID: 54186
Case created: 26th Jun 2017
Last edited: 30th Jun 2017
System: Vascular
Inclusion in quiz mode: Included

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