[Compression of the celiac tripod by the arcuate ligament of the diaphragm]

Abstract

A case of external compression of the coeliac trunk on the part of the lateral arcuate ligament is reported. A brief account of the questions still posed by Dunbar's syndrome is followed by the assertion that dynamic, not static, aortography must be performed since it is in itself sufficient to clinch the diagnosis. It is suggested that pain is not an expression of reduced arterial flow, but of compression of the coeliac plexus, with the results that surgical management must associate adventitiectomy with section of the arcuate ligament. This will ensure displacement of the plexus, and prevent possible postoperative periarterial fibrosis from causing the reappearance of pain by involving the nerve fibres.