Celiac compression syndrome / Median arcuate ligament syndrome

It is the narrowing of the proximal celiac artery which can result from extrinsic compression by the median arcuate ligament of the diaphragm or by the celiac ganglia.

Because both structures lie superior to the celiac origin, the typical angiographic appearance is of smooth asymmetric narrowing by compression from above and occasional caudad displacement of the proximal segment of the celiac artery .

The degree of stenosis may vary with respiration, diminishing during inspiration.

The clinical significance of the anatomic abnormality is controversial. Most patients with characteristic angiographic features of the celiac compression syndrome are asymptomatic. This in itself does not preclude the possibility that the abnormality could give rise to symptoms: many patients with severe atherosclerotic mesenteric stenosis are also asymptomatic. However, the occurrence of collateral filling of the celiac artery in association with celiac compression is convincing evidence that this abnormality can be hemodynamically significant.