The left crus is a tendinous band arising from the bodies and disc of L1-L2, shorter and smaller than the right crus. It passes upwards beside the aorta and joins the right crus through the median arcuate ligament, which forms the front of the aortic hiatus at T12. It usually contributes few if any fibres to the oesophageal hiatus.
| Muscle | |
|---|---|
| Attachment | Anterior bodies and intervertebral discs of L1-L2 |
Anchors the diaphragm to the lumbar spine and forms the left margin of the aortic hiatus
The left crus and the median arcuate ligament together bound the aortic hiatus, so a low-lying ligament can compress the coeliac trunk (median arcuate ligament syndrome). Like the right crus, it is approximated with sutures during hiatus hernia repair. On cross-sectional imaging it appears as a soft tissue band beside the aorta that should not be mistaken for a mass.
Left-sided diaphragmatic tears after blunt trauma are more common than right-sided ones and may extend into the crus, allowing stomach or bowel into the chest.
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