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The Roles of Celiac Trunk Angle and Vertebral Origin in Median Arcuate Ligament Syndrome

Ryan P Dyches1, Kelsey J Eaton1, Heather F Smith2,3

  • 1Department of Osteopathic Manipulative Medicine, Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ 85308, USA.

Diagnostics (Basel, Switzerland)
|February 7, 2020
PubMed

Insights

Median arcuate ligament syndrome (MALS) involves celiac trunk (CT) compression by the median arcuate ligament (MAL). Anatomical variations, particularly MAL/CT overlap, correlate with CT and SMA angles, impacting MALS understanding.

Area of Science:

  • Anatomy
  • Vascular Surgery
  • Gastroenterology

Background:

  • Median arcuate ligament syndrome (MALS) is caused by celiac trunk (CT) compression by the median arcuate ligament (MAL).
  • Gastrointestinal symptoms arise from reduced blood flow or nerve compression.
  • The precise anatomical basis of MALS remains unclear.

Purpose of the Study:

  • To investigate anatomical variations of the MAL and CT.
  • To determine correlations between MAL/CT overlap and CT/SMA angles.
  • To clarify the anatomical underpinnings of MALS.

Main Methods:

  • Cadaveric study of 35 subjects (17M/18F).
  • Assessment of MAL/CT overlap, CT/SMA origin angles, vertebral levels, and vessel diameters.
  • Statistical analysis of anatomical measurements and correlations.

Main Results:

  • Females showed higher rates of inferred MAL/CT overlap.
  • Significant correlations found between MAL/CT overlap and CT/SMA origin angles.
  • No significant difference in CT vertebral origin level based on MAL/CT overlap.

Conclusions:

  • MAL/CT overlap is significantly related to the angle of CT origination.
  • Findings provide clinical insights into the anatomy associated with MALS.
  • Further research can refine understanding and diagnosis of MALS.

Keywords:
celiac arteryceliac artery compression syndromediaphragmmedian arcuate ligament syndromesuperior mesenteric artery

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