Korean J Radiol.  2014 Aug;15(4):439-442. 10.3348/kjr.2014.15.4.439.

Clinical and Radiologic Review of Uncommon Cause of Profound Iron Deficiency Anemia: Median Arcuate Ligament Syndrome

• Gunduz Y
• Asil K
• Aksoy YE
• Tatli Ayhan L

• KMID: 1731046
• DOI: http://doi.org/10.3348/kjr.2014.15.4.439

Abstract

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

Keyword

Iron deficiency anemia; Median arcuate ligament syndrome; Gastric ulcer

MeSH Terms

Abdominal Pain/*etiology
Aged
Anemia, Iron-Deficiency/*etiology
Angiography/methods
Arterial Occlusive Diseases/radiography
Celiac Artery/*abnormalities/radiography
Constriction, Pathologic/complications/*radiography
Diaphragm
Humans
Male
Recurrence
Stomach Ulcer/complications/*radiography
Syndrome
Tomography, X-Ray Computed
Weight Loss

Figure

• 

  Fig. 1 Median arcuate ligament syndrome in 72-year-old male patient. A. Sagittal reformatted contrast enhanced CT angiography shows stenosis and aneurysm of celiac artery due to compression by median arcuate ligament (arrows). B. Three-dimensional reconstruction CT angiography shows severe stenosis and poststenotic dilatation (white arrows) of celiac artery. C. Axial CT image shows median arcuate ligaments (hollow arrows) and gastric mucasal thickening and contrast enhancement (white arrow).

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