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Median arcuate ligament syndrome

Case contributed by Mahmoud Yacout Alabd
Diagnosis certain

Presentation

Acute lower abdominal pain

Patient Data

Age: 71
Gender: Female

Tight ostial stenosis is seen at the celiac trunk ostium with the fibrous band making up the median arcuate ligament seen clearly compressing it from above. The artery and its branches showed, apart from some atherosclerotic changes, good distal opacification and caliber.

Case Discussion

Incidentally discovered celiac trunk compression by the median arcuate ligament causing tight ostial stenosis. The patient however turned out to have acute appendicitis which was the cause for her acute onset abdominal pain and presentation. The celiac compression seems rather asymptomatic.  The median arcuate ligament is a fibrous ligament crossing the aorta to connect the 2 diaphragmatic crurea.

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