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Median Arcuate Ligament Syndrome

Department of Radiology, Ochsner Clinic Foundation, New Orleans, Louisiana USA.

Address correspondence and reprint requests to Edward I. Bluth, MD, Department of Radiology, Ochsner Clinic Foundation, 1514 Jefferson Hwy, New Orleans, LA 70121 USA.

Objective. To describe the importance of obtaining erect views when evaluating the celiac artery with sonography. Methods. Two patients had duplex and color flow Doppler sonographic evaluations of the celiac artery, including inspiration, expiration, and erect views. Results. Both patients had elevated celiac artery velocities with inspiration and expiration. These results alone would suggest celiac artery stenosis. With erect views, the celiac artery velocities returned to normal. The addition of erect views allowed the correct diagnosis of median arcuate ligament syndrome to be made. Conclusions. When evaluating the celiac artery, it is important to include erect views to prevent misdiagnosis of celiac artery stenosis.

Key Words: celiac stenosis • Doppler sonography • median arcuate ligament syndrome • mesenteric ischemia