J Korean Surg Soc.  2013 Aug;85(2):93-95. 10.4174/jkss.2013.85.2.93.

Open surgical decompression of celiac axis compression by division of the median arcuate ligament

• Kim SJ
• Park YJ
• Yang SS
• Kim YW

• KMID: 2212524
• DOI: http://doi.org/10.4174/jkss.2013.85.2.93

Abstract

Median arcuate ligament syndrome is a rare cause of abdominal pain which results from compression of the celiac artery (CA) or rarely, the superior mesenteric artery by a ligament formed by the right and left crura of the diaphragm. We report a case of open surgical decompression of the CA by division of the median arcuate ligament for a 37-year-old female patient who had suffered from chronic postprandial epigastric pain and severe weight loss. We described clinical features, characteristic angiographic findings and details of the surgical procedure for the patient with this rare vascular problem.

Keyword

Median arcuate ligament; Celiac artery stenosis

MeSH Terms

Abdominal Pain
Axis, Cervical Vertebra
Celiac Artery
Decompression, Surgical
Diaphragm
Female
Humans
Ligaments
Mesenteric Artery, Superior
Weight Loss

Figure

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  Fig. 1 Computed tomographic angiography: celiac trunk stenosis. Compression of celiac artery (CA) makes an acute angle of CA (arrow).

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  Fig. 2 Operative finding. (A) Fibrous structure (in a vessel loop) compressing celiac artery (CA). (B) Mild residual stenosis (arrow) of CA after division of fibrous structure. CHA, common hepatic artery; SA, splenic artery.

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  Fig. 3 Follow-up computed tomographic angiography. After surgical decompression of celiac artery (CA), downward angulation of CA disappeared (arrow).

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