When a ligament squeezes a gut artery: scans pin down a rare cause of belly pain
Doppler ultrasound and CT angiography revealed a hook-shaped narrowing in a 27-year-old man with months of pain after meals.
Pain after eating, weight loss and nausea have many possible causes. One that is rarely considered is a band of tissue at the diaphragm pressing on the artery that supplies the upper abdominal organs.
Radiologists from Sivas and Aydın describe such a case in The Ulutas Medical Journal. A 27-year-old man had suffered worsening pain after meals for six months, while routine tests were normal.
Doppler ultrasound showed blood racing through a narrowed coeliac artery when he breathed out, with peak speeds of 383 cm per second, falling to 237 cm per second at full breath in. CT angiography then showed the typical hook-shaped narrowing, confirming median arcuate ligament syndrome. He was managed conservatively, with imaging follow-up.
The authors urge doctors to keep the condition in mind for young people with persistent upper abdominal pain, and to use non-invasive scans to find it.
Caveat: this is a single case report; it illustrates the imaging signs but cannot show how common the syndrome is.
Source: Nisa Başpınar et al. Median Arcuate Ligament Syndrome as A Rare Cause of Recurrent Chronic Abdominal Pain: Radiological Findings. Ulutas Med J 2019. doi:10.5455/umj.20190706071036.
Image: Figure 2 of the article, CC BY-NC 4.0.
