median arcuate ligament median arcuate ligament the median arcuate ligament is a ligament under the diaphragm that connects the right and left crura of diaphragm. median arcuate ligamentthe diaphragm. under surface.detailsidentifierslatinligamentum arcuatum medianumta98a04.4.02.005ta22343fma58281anatomical terminology structure the median arcuate ligament is formed by the right and left crura of the diaphragm. the crura connect to form an arch, behind which is the aortic hiatus, through which pass the aorta, the azygos vein, and the thoracic duct. variation in between 10% and 24% of people, the median arcuate ligament occurs very low. clinical significance compression of celiac artery and celiac ganglia by the median arcuate ligament can lead to the median arcuate ligament syndrome, which is characterized by abdominal pain, weight loss, and an epigastric bruit.