Median Arcuate Ligament Syndrome with Common Hepatic and Splenic Arteries Directly Originating from the Abdominal Aorta: A Case Report

Knowledge of the unpaired abdominal vasculature is important for uncomplicated operations. The absent celiac trunk has previously been reported; however, developmental alterations can result in a variety of branching patterns of the downstream arteries from the abdominal aorta.

A 53-year-old female patient with lymphoma underwent abdominopelvic computed tomography (CT) for staging. She had a history of postprandial off-and-on abdominal pain since her youth. CT scan revealed an absent celiac trunk with common hepatic and splenic arteries directly originating from the abdominal aorta. Compression of the median arcuate ligament had narrowed and angulated the 2 branches.

When the celiac trunk is absent, its main branches may separately arise from the abdominal aorta. Also, due to the displacement of these branches, their path and diameter can vary from the normal.