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Median arcuate ligament syndrome: a case report
Romeo A Lainez1, William S Richardson1
1Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA.
Background:
The median arcuate ligament passes superior to the origin of the celiac artery and is a continuation of the posterior diaphragm that wraps over the aorta. If it lies too low on the aorta, the ligament may cause symptoms of abdominal pain related to compression of the celiac artery.
Case Report:
An abdominal ultrasound in a 22-year-old woman with longstanding abdominal pain after eating showed elevated celiac artery velocities of >300 cm/s upon inspiration. Computed tomography angiography of the abdomen showed stenosis of the origin of the celiac artery and confirmed the diagnosis of median arcuate ligament syndrome. Laparoscopic release of the median arcuate ligament resulted in relief of the patient's symptoms.
Conclusion:
The diagnosis of median arcuate ligament syndrome should be considered in patients with postprandial abdominal pain that does not have a clearly established etiology.
