Compression of the left renal artery and celiac trunk by diaphragmatic crura

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.

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.

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).

After resection of keen, ganglion-like connective tissue structures (held with the Allis clamp), the lumen of the left renal artery increased immediately (arrow).