A 27 year old female, who had not any past medical history, presented with chronic post prandial pain for 10 months, during which she had experienced a 10 kg weight loss. Her whole abdomen sonogram was within normal limits. However, the computer tomography (CT) of the abdomen revealed a severe compression of celiac axis. According to her clinical symptoms and imaging findings, the patient is suffering from?
Median arcuate ligament syndrome: Celiac aery compression by the medial arcuate ligament (MAL) resulting in compromised blood flow and symptom causation. However, some patients are asymptomatic due to sufficient collateral supply from superior mesenteric circulation. This syndrome is more frequent among young females with a thin body habitus and comprises the classical triad: postprandial abdominal pain, epigastric bruit, and the presence of extrinsic celiac compression revealed by vascular imaging. The goal of MALS treatment is restoring normal blood flow in the celiac axis. Ref: Top Three Differentials in Radiology, edited by William T. O'Brien, Page 519.
Vasculitis
Peptic ulcer
Atherosclerosis of celiac aery
Median arcuate ligament syndrome