Figure 3 a, b.

A 40-year-old man presented with epigastric pain. Sagittal reconstructed arterial phase CT image (a) shows complete obstruction of the celiac trunk due to thickened MAL (asterisk) and the U-shaped configuration of the expected celiac trunk (dotted line), together with a large thrombosed aneurysm (arrowhead) and minimal narrowed superior mesenteric artery orifice. Superior mesenteric angiography (b) reveals collateral circulation and multiple aneurysms (arrowheads) in the pancreaticoduodenal arcades and retrograde contrast filling of the celiac trunk branch vessels with a synchronous splenic artery aneurysm (arrow).