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Median arcuate ligament syndrome

Case contributed by Eric F Greif
Diagnosis certain

Presentation

Malignant neoplasm of the breast, evaluate for metastasis.

Patient Data

Age: 80 years
Gender: Female

There is acute angulation with indentation upon the superior aspect of celiac axis. This scan was performed during inhalation, therefore this is true stenosis secondary to median arcuate ligament (white arrow).

Also, there is mild prominence and tortuosity of the splenic artery which may be compensating for long-standing celiac axis stenosis.

Case Discussion

In median arcuate ligament syndrome (MALS), compression of the celiac axis compromises blood flow and causes symptoms.

For all we know the patient has not presented to radiology with any complaint of abdominal pain. Therefore, strictly speaking, this compression of the celiac axis would only be described, but it may not be necessarily MALS. 

The imaging findings must, therefore, be correlated with the clinical history.

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