Pancreaticoduodenal Artery Aneurysm Associated with Median Arcuate Ligament Syndrome

Aneurysm of the pancreaticoduodenal artery arcade has a well-documented association with occlusion of the celiac axis. The etiology of celiac occlusion is most commonly atherosclerotic disease. Occlusion or severe stenosis of the celiac artery secondary to a median arcuate ligament is less frequently encountered, and symptoms can be vague or completely lacking. We present a case of an asymptomatic 25-year-old woman who, in the course of being evaluated as a potential donor for living-related kidney transplantation, underwent a computed tomography angiography (CTA) scan that revealed an aneurysm of the pancreaticoduodenal artery. The aneurysm, as well as severe compression of the celiac axis by the median arcuate ligament, was confirmed by catheter angiography. The patient underwent successful endovascular coil embolization of the aneurysm. In our review of the existing medical literature, our patient is the youngest reported case of pancreaticoduodenal aneurysm caused by median arcuate ligament syndrome.