median arcuate ligament syndrome

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median arcuate ligament syndrome

A condition characterised by compression of the coeliac artery, and possibly also coeliac ganglia, by the median arcuate ligament, resulting in abdominal pain at meal time, often leading to weight loss, and typically accompanied by a buit. While the median arcuate ligament crosses in front of the coeliac artery in up to 25% of the general population, it is symptomatic in only 1%; it is more commonly symptomatic in women age 20 to 40, especially if thin.

Clinical findings
Abdominal pain, anorexia, weight loss, nausea, exercise intolerance, gastroparesis.

Imaging
Angiography: focal narrowing of proximal coeliac artery and post-compression dilatation; hooked contour of the artery.

Management
Surgery: divide ligament, remove coeliac ganglion; bypass graft if needed.
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