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Rare disease
A rare cause of abdominal angina
  1. Gian Piero Carboni1,
  2. Silvia Visconti2,
  3. Sofia Battisti2,
  4. Bruno Beomonte Zobel2
  1. 1Department of Nuclear Cardiology, Università Campus Bio- Medico, Rome, Italy
  2. 2Department of Radiology, Università Campus Bio-Medico, Rome, Italy
  1. Correspondence to Professor Gian Piero Carboni, g.carboni{at}unicampus.it

Summary

The authors report a case of a young male with median arcuate ligament syndrome (MALS). An abnormally low insertion of the median arcuate ligament fibres caused extrinsic compression and stenosis of the coeliac trunk. However, partial dissection of ligament fibres by laparoscopic surgery did not relieve abdominal angina. Multidetector CT confirmed that MALS did not differ from the preoperative scan. The arcuate ligament compressed the coeliac trunk on expiration, thereby eliciting occlusion of the coeliac trunk. Inspiration induced decompression of the ligament with partial release of occlusion of the coeliac trunk. This leads to hypo-perfusion of intestinal organs and abdominal angina. Considering the severe impairment of quality of life, open surgery for decompression of the coeliac trunk with vascular reconstruction is a reasonable option.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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