The indentation at proximal celiac trunk
with severe stenosis was best presented on parasagittal reformation CT (Figure 3).
The branches of the celiac trunk
. Acta Anat, 122:110-4, 1985.
A keyword search of the electronic medical records and radiology reports in the picture archiving and communication system between August 2010 and July 2017 was performed using the terms "median arcuate ligament (MAL) or "celiac trunk
abdominal aorta, celiac trunk
, superior mesenteric artery and inferior mesenteric artery.
Caption: Figure 2: Intraoperative perspective after distal pancreatectomy with en bloc resection of the celiac trunk
as well as portal vein segment and successful reconstruction by interposition graft.
The celiac trunk
branched into two vessels: the left gastric artery and a hepatosplenic trunk, which further divided into splenic and common hepatic arteries (Figure 1).
Assessment of the regional blood circulation revealed a statistically significant reduction in the celiac trunk
diameter and decrease in blood flow velocity in the celiac trunk
in both groups 1 and 2 as compared with normal values of 0.99[+ or -]0.14 cm for celiac trunk
diameter and 14.4[+ or -]0.9 cm/s for blood flow velocity.
In the present case, we reported that there were variations in both right and left hepatic arteries and no common hepatic artery from the celiac trunk
; this makes LND more difficult than that for arteries with a standard anatomy.
The aneurysm was associated with severe celiac trunk
stenosis (Figure 2).
In 14 patients the celiac trunk
lesion was secondary to compression by MAL, while in only 1 significant, proximal celiac trunk
atherosclerosis was present.
A total of 314 aneurysms arose from the initial segment of splenic artery and in normal celiac trunk
, 4 from abdominal aorta, 3 from the superior mesenteric artery, and 6 with abnormal combination of hepatic artery, splenic artery, and mesenteric artery.
This can lead to dynamic compression of the celiac trunk
resulting in postprandial abdominal pain, nausea, vomiting and weight loss.1,2,6 This condition is called median arcuate ligament syndrome (MALS) and is more common in thin women.1,6,7 It is defined by the dynamic compression and narrowing of proximal celiac artery by the anomalous MAL.
An initial computed tomography (CT) scan and Doppler ultrasonography revealed an intravascular filling defect in the celiac trunk
. The patient had no history of smoking, drinking, hypertension, or trauma.
At the emerging of celiac trunk
, abdominal aorta presented circumferential parietal thrombosis, about 7.4 mm thickness.
In classic anatomy, the celiac trunk
originates anteriorly from the abdominal aorta at T12 level, just as the aorta enters the abdomen.