Median arcuate ligamentum syndrome: Four case reports

Figure 1 Imaging examinations of case 1. A: Computed tomography (CT) shows the celiac trunk originating from the upper abdominal aorta rather than in the normal case; B: CT angiography shows narrowing of the orfice of the celiac trunk due to compression by the diaphragmatic crus.

Figure 2 Computed tomography shows the proximal celiac axis narrowing with collateral vessel formation. A: Axial view; B: Sagittal view; C: Computed tomography angiography confirmed the diagnosis.

Figure 3 Computed tomography angiography shows mild luminal narrowing at the orifice of the celiac trunk with adjacent abdominal aortic calcification. A: Axial view; B: Sagittal view.

Figure 4 Imaging examinations of case 4. A: Computed tomography (CT) showing the surrounding celiac trunk, where post-stenotic dilatation is seen; B: The median arcuate ligamentum compresses the narrowed area; C: CT angiography showing that the celiac trunk orifice is significantly narrowed, and post-stenotic dilatation is also seen.

Figure 5 Algorithm for median arcuate ligamentum syndrome diagnosis through imaging modalities and clinical history. MALS: Median arcuate ligamentum syndrome; NRS: Numeric pain rating scale; GB: Gallbladder; CT: Computed tomography; CTA: Computed tomography angiography.