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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
- Median arcuate ligament syndrome (MALS)
Synonyms
- Celiac arcuate ligament syndrome
- Celiac axis syndrome
- Celiac trunk compression syndrome
- Dunbar syndrome
Definitions
- Median arcuate ligament
- Fibrous band that bridges diaphragmatic crura anteriorly around aorta, creating aortic hiatus centrally
- Usually originates above celiac artery origin, just superior to level of L1 vertebral body
- In 10-24% of all people, ligament is low lying, sitting anterior to celiac axis
- May result in some degree of compression &/or angulation of vessel, degree of which can vary throughout respiratory cycle
- MALS diagnosed when patient has abnormal morphology of median arcuate ligament and celiac artery combined with clinical symptoms, typically including abdominal pain, weight loss, nausea, and others
- Clinical symptoms or imaging findings alone not sufficient for diagnosis as many imaging characteristics found in asymptomatic people
- Median arcuate ligament
IMAGING
General Features
Ultrasonographic Findings
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Reporting Tips
Selected References
- Kim EN et al: Median arcuate ligament syndrome-review of this rare disease. JAMA Surg. 151(5):471-7, 2016
- Fong JK et al: Imaging findings and clinical features of abdominal vascular compression syndromes. AJR Am J Roentgenol. 203(1):29-36, 2014
- AbuRahma AF et al: Mesenteric/celiac duplex ultrasound interpretation criteria revisited. J Vasc Surg. 55(2):428-436.e6; discussion 435-6, 2012
- Chou JW et al: Celiac artery compression syndrome: an experience in a single institution in taiwan. Gastroenterol Res Pract. 2012:935721, 2012
- Gruber H et al: Ultrasound of the median arcuate ligament syndrome: a new approach to diagnosis. Med Ultrason. 14(1):5-9, 2012
- Scholbach T: Celiac artery compression syndrome in children, adolescents, and young adults: clinical and color duplex sonographic features in a series of 59 cases. J Ultrasound Med. 25(3):299-305, 2006
- Horton KM et al: Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics. 25(5):1177-82, 2005
- Sproat IA et al: US case of the day. Median arcuate ligament syndrome (celiac artery compression syndrome). Radiographics. 13(6):1400-2, 1993
- Cornell SH: Severe stenosis of the celiac artery. Analysis of patients with and without symptoms. Radiology. 99(2):311-6, 1971
- Dunbar JD et al: Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med. 95(3):731-44, 1965
- HARJOLA PT: A rare obstruction of the coeliac artery. Report of a case. Ann Chir Gynaecol Fenn. 52:547-50, 1963
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Abbreviations
- Median arcuate ligament syndrome (MALS)
Synonyms
- Celiac arcuate ligament syndrome
- Celiac axis syndrome
- Celiac trunk compression syndrome
- Dunbar syndrome
Definitions
- Median arcuate ligament
- Fibrous band that bridges diaphragmatic crura anteriorly around aorta, creating aortic hiatus centrally
- Usually originates above celiac artery origin, just superior to level of L1 vertebral body
- In 10-24% of all people, ligament is low lying, sitting anterior to celiac axis
- May result in some degree of compression &/or angulation of vessel, degree of which can vary throughout respiratory cycle
- MALS diagnosed when patient has abnormal morphology of median arcuate ligament and celiac artery combined with clinical symptoms, typically including abdominal pain, weight loss, nausea, and others
- Clinical symptoms or imaging findings alone not sufficient for diagnosis as many imaging characteristics found in asymptomatic people
- Median arcuate ligament
IMAGING
General Features
Ultrasonographic Findings
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Image Interpretation Pearls
Reporting Tips
Selected References
- Kim EN et al: Median arcuate ligament syndrome-review of this rare disease. JAMA Surg. 151(5):471-7, 2016
- Fong JK et al: Imaging findings and clinical features of abdominal vascular compression syndromes. AJR Am J Roentgenol. 203(1):29-36, 2014
- AbuRahma AF et al: Mesenteric/celiac duplex ultrasound interpretation criteria revisited. J Vasc Surg. 55(2):428-436.e6; discussion 435-6, 2012
- Chou JW et al: Celiac artery compression syndrome: an experience in a single institution in taiwan. Gastroenterol Res Pract. 2012:935721, 2012
- Gruber H et al: Ultrasound of the median arcuate ligament syndrome: a new approach to diagnosis. Med Ultrason. 14(1):5-9, 2012
- Scholbach T: Celiac artery compression syndrome in children, adolescents, and young adults: clinical and color duplex sonographic features in a series of 59 cases. J Ultrasound Med. 25(3):299-305, 2006
- Horton KM et al: Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics. 25(5):1177-82, 2005
- Sproat IA et al: US case of the day. Median arcuate ligament syndrome (celiac artery compression syndrome). Radiographics. 13(6):1400-2, 1993
- Cornell SH: Severe stenosis of the celiac artery. Analysis of patients with and without symptoms. Radiology. 99(2):311-6, 1971
- Dunbar JD et al: Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med. 95(3):731-44, 1965
- HARJOLA PT: A rare obstruction of the coeliac artery. Report of a case. Ann Chir Gynaecol Fenn. 52:547-50, 1963
