Journal Information
Vol. 80. Issue 2.
Pages 163-164 (April - June 2015)
Vol. 80. Issue 2.
Pages 163-164 (April - June 2015)
Clinical image in Gastroenterology
Open Access
Median arcuate ligament syndrome
Síndrome del ligamento arcuato mediano
P. Demelo-Rodríguez
Corresponding author

Corresponding author.
, A. Marcelo-Ayala, R.D. González-Benítez
Departamento de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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A 73-year-old man had a past history of high blood pressure, hypercholesterolemia, and chronic ischemic cardiopathy. He came to our center with symptoms of postprandial abdominal pain in the epigastrium. Abdominal computed angiotomography showed permeability and normal caliber of the superior and inferior mesenteric arteries. Stricture due to median arcuate ligament impression was identified at the level of the emergence of the celiac trunk (Figs. 1 and 2).

Figure 1.

Axial CT image at the level of the emergence of the celiac trunk (arrowhead), in which a linear hypodense image is identified that separates it from the abdominal aorta (white arrows) and represents the arcuate ligament impression.

Figure 2.

Sagittal CT image. The median arcuate ligament (white arrow) is located anterior to the celiac trunk. The characteristic stricture can be seen proximal to the celiac trunk (arrowhead).


The median arcuate ligament is a fibrous arc that joins the diaphragmatic columns on both sides of the aortic hiatus. It is usually located above the celiac trunk, but its situation is anterior to it in 24% of the general population. When this anatomic alteration compromises blood flow it is known as median arcuate ligament syndrome, or Dunbar's syndrome. Treatment is surgical, whether or not it is associated with celiac trunk revascularization, through angioplasty and stent placement. In our case, the patient rejected the surgical option.

Ethical responsibilitiesProtection of persons and animals

The authors declare that the procedures followed conformed to the ethical standards of the responsible committee on human experimentation and were in accordance with the World Medical Association and the Declaration of Helsinki.

Data confidentiality

The authors declare that they have followed the protocols of their work center in relation to the publication of patient data.

Right to privacy and informed consent

The authors have obtained the informed consent of the patients and/or subjects referred to in the article. This document is in the possession of the corresponding author.

Financial disclosure

No financial support was received in relation to this study/article.

Conflict of interest

The authors declare that there is no conflict of interest.

Please cite this article as: Demelo-Rodríguez P, Marcelo-Ayala A, González-Benítez RD. Síndrome del ligamento arcuato mediano. Revista de Gastroenterología de México. 2015;80:163–164.

Revista de Gastroenterología de México
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