Celiac Artery Compression by the Median Arcuate Ligament With Potential Contribution From an Overlying Arterial Branch: A Case Report

Celiac axis compression, also known as median arcuate ligament syndrome, is a relatively rare vascular condition characterized by extrinsic compression of the celiac artery by the median arcuate ligament of the diaphragm. However, compression by an overlying arterial branch represents a unique and less commonly reported etiology. This case study examines a patient presenting with symptoms suggestive of mesenteric ischemia, including postprandial abdominal pain and unintentional weight loss. Duplex ultrasound and computed tomography angiography imaging demonstrated celiac artery compression consistent with median arcuate ligament compression. However, an overlying arterial branch was also identified, potentially contributing to the observed mechanical compression. The definitive etiology remains complex and not entirely straightforward. This rare presentation underscores the importance of meticulous vascular assessment to identify atypical causes of celiac artery compression when evaluating patients with unexplained abdominal pain.