A rare case: celiac artery compression syndrome in an asymptomatic child

Alehan, Dursun; Dogan, Omer Faruk

doi:10.1016/j.jpedsurg.2003.12.037

Cited by 16 publications

(22 citation statements)

References 9 publications

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“…Most of patients are young [1][2][3][4]8], thin individuals with acute post prandial (beginning from 15 to 30 minutes after meals), exercise related [1] or chronic epigastric pain, hyperemesis, vomiting, diarrhoea and weight loss [1][2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Clinical manifestations are vague and diagnosis may rely on findings at duplex and color flow Doppler sonography [2,8], angiographic [2,3,19,20,21,25], CT [3,4,9,21] or MR [2,6,22] imaging but differentiation between clinically relevant celiac artery compression and incidental narrowing may be difficult [16,22].…”

Section: Discussionmentioning

confidence: 99%

“…Celiac artery compression also known as median arcuate ligament or Dunbar's syndrome is an uncommon disorder characterized, in symptomatic patients, by transient postprandial or exercise-related or chronic epigastric pain, hyperemesis, vomiting, diarrhoea and weight loss [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…It may be considered also in asymptomatic patients presenting abdominal bruit or with palpated thrill in the upper epigastrium at physical examination [2,3,5,7].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of median arcuate ligament is not clearly established, the majority of literature consisting of isolated reports [1][2][3][4]8].…”

Section: Introductionmentioning

confidence: 99%

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Celiac Artery Compression by the Median Ligament: An Uncommon Cause of Abdominal Pain in the Emergency Department. Report of a Case~!2009-12-31~!2010-05-06~!2010-07-06~! DONE

Ferri¹,

Magrini²,

Capotondi³

et al. 2010

TOEMJ

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Abstract:The Authors report a case of a patient presenting in the Emergency Department (ED) with severe epigastric pain refractory to therapeutic treatment, with onset after forced ice water ingestion caused by joking compression of a soft PET ® bottle during drinking.The Angio MR and angiography performed, after exclusion of suspected esophagus rupture and other esophago-gastric diseases, to rule out an ischemic origin of the pain demonstrate a stenosis of the celiac artery resulting from median arcuate ligament narrowing, the so-called Dunbar's Syndrome.The Dunbar's Syndrome is uncommon and some aspects such as the vascular etiology of symptoms are still controversial.In this report clinical presentation, differential diagnosis and pathophysiology of this disease are discussed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It may be considered also in asymptomatic patients presenting abdominal bruit or with palpated thrill in the upper epigastrium at physical examination [2,3,5,7].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of median arcuate ligament is not clearly established, the majority of literature consisting of isolated reports [1][2][3][4]8].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Celiac Artery Compression by the Median Ligament: An Uncommon Cause of Abdominal Pain in the Emergency Department. Report of a Case~!2009-12-31~!2010-05-06~!2010-07-06~! DONE

Ferri¹,

Magrini²,

Capotondi³

et al. 2010

TOEMJ

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Clinical anatomy of celiac artery compression syndrome: A review

et al. 2007

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Anatomic variations are often responsible for a variety of clinical conditions. In this review we investigate compression of the celiac artery and the superior mesenteric artery by the median arcuate ligament (MAL), diaphragmatic crura, or the celiac nerve plexus. This clinical condition known as celiac artery compression syndrome (CACS) has proven controversial in definition and relevance. This condition was first described as chronic abdominal pain because of the mesenteric ischemia caused by extrinsic compression of the celiac artery. Dunbar and others presented surgical approaches to decompress the celiac artery by releasing the MAL. Definitive answers have been sought to classify and relieve the clinical symptoms patients experience postprandially. Persistent symptoms following surgical treatment for CACS have led investigators to question the existence of this disease. Advances in technology such as angiographic MRI and color duplex ultrasonography have refreshed the importance of considering compression of the celiac artery during differential diagnoses. Because of the varying anatomic etiologies of disease, it is not possible to pinpoint a single cause for CACS. Potential etiologies for compression of the celiac artery include a "high take off" origin of the celiac artery compressed by normal diaphragmatic crura and MAL, a normal origin of the celiac artery with long diaphragmatic crura and MAL, large bilaterally fused celiac ganglia (with or without the involvement of the superior mesenteric ganglia) compressing the celiac trunk, celiacomesenteric trunk compression by diaphragmatic crura and MAL, or combinations of the above mentioned entities. In this review we describe potential sources of compression of the celiac artery by regional structures and treatments of CACS in an effort to justify the relevance of CACS in modern medicine.

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