CASE REPORT article
Front. Surg.
Sec. Vascular Surgery
Median arcuate ligament syndrome with an anomalous origin of the right inferior phrenic artery from the celiac artery: a case report
Provisionally accepted
- Suzhou BenQ Medical Center, Jiangsu, China
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Median arcuate ligament syndrome (MALS) is a rare vascular disorder. We report a 72-year-old male with MALS found to have an anomalous right inferior phrenic artery (RIPA) originating from the cel iac artery (CA), which was not detected on preoperative computed tomography angiography (CTA). During laparoscopic decompression, this vessel was encountered unexpectedly. A temporary clampin g test was performed, confirming no diaphragmatic or hepatic ischemia, after which it was safely liga ted. The CA was then fully decompressed. Postoperatively, the patient's symptoms resolved complete ly. This case underscores that significant vascular anomalies may only be revealed intraoperatively. T he described clamping technique provides a simple, safe method for real-time functional assessment, aiding critical surgical decisions when managing such unforeseen anatomical variations.
Keywords: anatomical variation, Celiac Artery, Laparoscopic decompression, Median arcuate ligament syndrome, Right inferior phrenic artery
Received: 12 Nov 2025; Accepted: 31 Jan 2026.
Copyright: © 2026 Zhu, Chen and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhipeng Yang
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