A variant of the median arcuate ligament syndrome: are sagittal images enough for diagnosis?

Median arcuate ligament syndrome (MALS), also known as celiac artery compression syndrome, is a rare cause of abdominal discomfort, postprandial pain and weight loss. Doppler ultrasonography (USG), computed tomography (CT), magnetic resonance imaging (MRI), and selective catheter angiography can be used to identify this abnormality. Classically, the "fish hook" appearance is seen on sagittal images. In our case, mild stenosis (20 %) was seen at the origin of the celiac artery without typical "fish hook" appearance. Higher degree stenosis (55 %) was demonstrated on axial images. We are presenting a rare case of a MALS caused by prominent crura.