Celiac Artery Compression by the Median Ligament: An Uncommon Cause of Abdominal Pain in the Emergency Department. Report of a Case

The Authors report a case of a patient presenting in the Emergency Department (ED) with severe epigastric pain refractory to therapeutic treatment, with onset after forced ice water ingestion caused by joking compression of a soft PET® bottle during drinking. The Angio MR and angiography performed, after exclusion of suspected esophagus rupture and other esophago-gastric diseases, to rule out an ischemic origin of the pain demonstrate a stenosis of the celiac artery resulting from median arcuate ligament narrowing, the so-called Dunbar’s Syndrome. The Dunbar’s Syndrome is uncommon and some aspects such as the vascular etiology of symptoms are still controversial. In this report clinical presentation, differential diagnosis and pathophysiology of this disease are discussed.