Pediatric Median Arcuate Ligament Syndrome

  • Etiology: External compression by the median arcuate ligament on the celiac axis causing bowel ischemia resulting in abdominal pain
  • Imaging:
    — Focal narrowing of the superior aspect of the proximal celiac trunk forming a hooked or J appearance
    — Post-stenotic dilatation or evidence of collateral formation
    — Absence of associated atherosclerosis
  • DDX:
  • Complications:
  • Treatment: Surgical
  • Clinical: Present with abdominal pain

Radiology Cases of Median Arcuate Ligament Syndrome

CT of median arcuate ligament syndrome
Sagittal MIP (left) and 3D (right) CT with contrast of the abdomen in the venous phase obtained in expiration shows focal narrowing of the superior aspect of the proximal celiac trunk resulting in it having a hooked or J appearance with the absence of associated atherosclerosis.