Case Of the Week (COW) 28 Dec 2014
Answer:
Median Arcuate Ligament Syndrome.
Findings:
CT Angiogram sagittal and Axial images - MIP and VR images reveal a characteristic kinking of the proximal celiac artery with a hook like appearance and post stenotic dilatation.
Discussion:
Imaging features are consistent with Median Arcuate Ligament Syndrome. The median arcuate ligament is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. The ligament usually passes superior to the origin of the celiac axis. Occasionally , the ligament inserts low and thus crosses the proximal portion of the celiac axis, causing compression ,resulting in abdominal pain.
Ref: Median Arcuate Ligament Syndrome: Evaluation with CT Angiography Elliot K. Fishman et al Sep 2005, Vol. 25:1177–1182
Contributed By:
Dr. Babu Peter, Dr. Srinivasa Raman, Dr. Suriya Kumar
Consultant Radiologists
BIR, Anderscan Diagnostics
Answer:
Median Arcuate Ligament Syndrome.
Findings:
CT Angiogram sagittal and Axial images - MIP and VR images reveal a characteristic kinking of the proximal celiac artery with a hook like appearance and post stenotic dilatation.
Discussion:
Imaging features are consistent with Median Arcuate Ligament Syndrome. The median arcuate ligament is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus. The ligament usually passes superior to the origin of the celiac axis. Occasionally , the ligament inserts low and thus crosses the proximal portion of the celiac axis, causing compression ,resulting in abdominal pain.
Ref: Median Arcuate Ligament Syndrome: Evaluation with CT Angiography Elliot K. Fishman et al Sep 2005, Vol. 25:1177–1182
Contributed By:
Dr. Babu Peter, Dr. Srinivasa Raman, Dr. Suriya Kumar
Consultant Radiologists
BIR, Anderscan Diagnostics