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Arcuate ligament syndrome is a condition where the celiac artery is compressed by the median arcuate ligament, causing symptoms such as abdominal pain, weight loss, nausea, and vomiting. It affects over 10% of the world’s population, with women being more frequently affected. Diagnosis is done through ruling out other conditions and using imaging techniques. Treatment involves surgical procedures, with the prognosis varying based on age, mental health, and lifestyle.
Arcuate ligament syndrome, also called median arcuate ligament syndrome, is a condition in which the celiac artery becomes compressed by the median arcuate ligament under the diaphragm. Symptoms of this disorder include abdominal pain, weight loss, nausea, and vomiting. In some cases, patients may also experience an abdominal murmur, an unusual rushing noise that occurs when blood passes a blocked artery. The condition is believed to affect over 10% of the world’s population, with around 1% reporting severe symptoms. Women are affected more frequently than men, but anyone in their 20s or 30s can suffer from this syndrome.
Along with the painful side effects, people who have chronic arcuate ligament problems can experience serious complications. Gastroparesis as a side effect most often affects women and is characterized by partial paralysis of the stomach that results in the stomach contents emptying slower than normal. The connection between arcuate ligament syndrome and gastroparesis could stem from unusual weight loss that resembles symptoms of anorexia nervosa. Aneurysm of certain arteries associated with the pancreas, duodenum and lower intestine can also afflict people who have this type of ligament condition and is a potentially life-threatening disease.
To confidently diagnose arcuate ligament syndrome, healthcare professionals must first rule out other conditions that have similar symptoms. By testing for — and ruling out — other causes of celiac artery compression, doctors may begin to suspect problems with the arcuate ligament as the source of the affliction. Under the direction of a doctor, radiology technicians typically screen for the disorder with ultrasound or magnetic resonance angiography. By following one of these procedures, technicians help doctors confirm the diagnosis using computerized systems such as computed tomography (CT), which creates a three-dimensional image of the affected area.
Treatment consists of several surgical procedures. Open separation of the median arcuate ligament in combination with extraction of the celiac ganglia is the most common form of surgery. If this approach fails to restore proper blood flow through the celiac artery, doctors may opt for celiac artery revascularization in the form of patch angioplasty or aortoceliac bypass surgery. A less invasive form of laparoscopic treatment might also produce successful artery decompression in some patients, but relapses can occur after the procedure.
The prognosis for patients who have arcuate ligament syndrome varies based on age, mental health, and lifestyle. People between the ages of 40 and 60 typically remain asymptomatic after receiving treatment, and younger patients show a higher overall recurrence rate. Factors such as drug or alcohol abuse, excessive weight loss, and psychiatric conditions can also have a negative effect on a patient’s recovery.
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