Compression of the left renal artery and celiac trunk by diaphragmatic crura Gabor Gaebel, MD, Irene Hinterseher, MD, Hans Detlev Saeger, MD, Hendrik.

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Presentation transcript:

Compression of the left renal artery and celiac trunk by diaphragmatic crura Gabor Gaebel, MD, Irene Hinterseher, MD, Hans Detlev Saeger, MD, Hendrik Bergert, MD Journal of Vascular Surgery Volume 50, Issue 4, Pages 910-914 (October 2009) DOI: 10.1016/j.jvs.2009.05.004 Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 1 Musculotendinous fibers (small arrows) originating from the left diaphragmatic crus impinging upon the origin of the left renal artery (LRA) are well demonstrated in the coronal computed tomography (CT) slices. The CT scan was performed in inspiration, showing a high-grade stenosis of the LRA (big arrow) and an inferiorly and medially course from its origin, which is just shortly underneath the origin of the celiac trunk. Journal of Vascular Surgery 2009 50, 910-914DOI: (10.1016/j.jvs.2009.05.004) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 2 The celiac trunk course inferiorly from its origin, the proximal portions pulled down an in toward the aorta, causing severe narrowing (>80%; big arrow) by the median arcuate ligament (small arrows) well demonstrated in the sagittal computed tomography (CT) slices. Journal of Vascular Surgery 2009 50, 910-914DOI: (10.1016/j.jvs.2009.05.004) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 3 Magnetic resonance angiography performed in expiration discloses a mild ostial stenosis of the celiac artery. But, performed during inspiration, a high-grade stenosis is depicted (arrow). Journal of Vascular Surgery 2009 50, 910-914DOI: (10.1016/j.jvs.2009.05.004) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 4 After resection of keen, ganglion-like connective tissue structures (held with the Allis clamp), the lumen of the left renal artery increased immediately (arrow). Journal of Vascular Surgery 2009 50, 910-914DOI: (10.1016/j.jvs.2009.05.004) Copyright © 2009 Society for Vascular Surgery Terms and Conditions