Median arcuate ligament syndrome often poses a diagnostic challenge: A literature review with a scope of our own experience

Figure 1 Magnetic resonance angiography with a respiratory variation protocol. A-C: Evident stenosis of the celiac artery and post-stenotic dilatation.

Figure 2 Intraoperative images. A: Vessel loop around the left gastric artery; B: Careful dissection along the diaphragmatic crura; C: Dissection continues as the aorta is starting to be exposed and relieved from the extrinsic pressure of the diaphragmatic crura and the median arcuate ligament; D: Exposure of the abdominal aorta after the dissection of the diaphragmatic crura, the median arcuate ligament, and the neural fibers of the celiac plexus; E: Final look of the abdominal aorta along with the recognition of an aberrant blood vessel towards the liver.