PMC3169899_01
Axial CTA shows compression of the celiac axis by the median arcuate ligament (arrow).
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F1
A repeat colonoscopy showed no ulcers, but ultrasound and a subsequent CT angiogram (CTA) revealed compression of the celiac axis [Figure 1].
Sagittal CTA shows compression (arrow) of the celiomesenteric trunk by the median arcuate ligament with post-stenotic dilatation of the celiac and superior mesenteric arteries (arrowheads).
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F2
This was confirmed by sagittal [Figure 2] and three-dimensional reconstructions [Figure 3] that showed a common origin of the celiac axis and superior mesenteric artery (SMA) with approximately 70% narrowing, and post-stenotic dilation of the celiac axis and SMA.
(a) Sagittal oblique three-dimensional (3D) volume rendered (VR) image of the celiomesenteric trunk (arrow). (b) Magnified view of 3D VR image shows stenosis (arrow) at the origin of the celiomesenteric trunk.
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F3
This was confirmed by sagittal [Figure 2] and three-dimensional reconstructions [Figure 3] that showed a common origin of the celiac axis and superior mesenteric artery (SMA) with approximately 70% narrowing, and post-stenotic dilation of the celiac axis and SMA.
Coronal CT abdomen with IV contrast (status post bypass surgery), shows thrombotic occlusion (arrow) of the celiac vascular graft.
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F4
Of note, the patient developed a post-op thrombotic occlusion of the celiac vascular graft [Figure 4].