A Case of a Right Gastric Artery Aneurysm Caused by the Collateral Flow Changes Due to the Coexistence of Median Arcuate Ligament Syndrome and a Celiac Artery Anomaly

A man in his 60s presented with severe epigastric pain. Abdominal computed tomography revealed an aneurysm of the right gastric artery, which branched from an aberrant gastroduodenal artery originating from the axis of the splenic artery. Other vascular anomalies included a left gastric artery arising directly from the aorta and several additional arterial variations. Computed tomography also revealed stenosis of the axes of the celiac artery and left gastric artery. The aneurysm was thought to be caused by the stenosis due to median arcuate ligament syndrome. Transcatheter arterial embolization was successfully performed. This case highlights that median arcuate ligament syndrome combined with vascular anomalies can alter hemodynamics and lead to the development of uncommon gastric artery aneurysms.