A Rare Cause of Mesenteric Ischemia: Celiac Axis Compression Syndrome

Tseng, Yu Chi; Tseng, Chun Kai; Chou, Jen Wei; Lai, Hsueh Chou; Hsu, Chang Hu; Cheng, Ken Sheng; Peng, Cheng Yuan; Chen, Yung‐Fang

doi:10.2169/internalmedicine.46.6424

Cited by 11 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical reports demonstrate that some body position postures have been adopted by patients suffering from this syndrome in order to relieve pain. The relief came adopting a knee-chest position (Dunbar et al;Marable et al, 1966;Fadhli;Harjola, 1968;Houdard et al, 1970;Leger et al, 1970;Drèze et al;Joubaud et al;Abate et al, 1980;Lawson & Ochsner, 1984;Mulder et al, 1971;Tseng et al, 2007), by abdominal pressure (Lawson & Ochsner), by resting (Edwards et al, 1970), by lateral decubitus (Joubaud et al) and in recumbency position (Leger et al, 1970). It was suggested that the knee-chest position would relieve the pressure on the celiac trunk by gravitating the viscera and diaphragm forward (Fadhli).…”

Section: Relationship Between Body Posture and Painmentioning

confidence: 99%

A Review on the Celiac Trunk Compression Syndrome: Some Anatomic Clinical-Surgical Aspects

Petrella

Prates

2008

Int. J. Morphol.

View full text Add to dashboard Cite

show abstract

Section: Relationship Between Body Posture and Painmentioning

confidence: 99%

A Review on the Celiac Trunk Compression Syndrome: Some Anatomic Clinical-Surgical Aspects

Petrella

Prates

2008

Int. J. Morphol.

View full text Add to dashboard Cite

show abstract

“…One small study suggested that serum lactate can help make the diagnosis of AMI. This study found that increased plasma lactate level had a sensitivity of 96% for recognizing acute mesenteric ischemia in patients with abdominal complaints 19 .…”

Section: Discussionmentioning

confidence: 64%

The role of imaging studies in critically ill medical patients with mesenteric ischemia

2013

SWRCCC

View full text Add to dashboard Cite

CaseA 75-year-old man with a history of dementia living in a nursing home presented with septic shock with no definite source of infection and acute respiratory failure. He was on a moderate dose of norepinephrine and ventilator support for three days without improvement. His physical examination revealed abdominal distention with decreased bowel sounds. Do we need an abdominal CT scan in this patient? DisCussionImaging studies in critically ill patients in intensive care units help guide treatment. The most widely used radiographic studies that are non-invasive and associated with small or no radiation exposure available at the bedside in the ICU include chest radiography, plain abdominal radiography, and ultrasonography. Plain abdominal films are usually the first imaging studies ordered, are universally available, and are inexpensive 1, 2 . However, plain abdominal imaging is rarely helpful in diagnosis and has a low sensitivity and specificity in patients with an acute abdomen 3, 4 . Moreover, information obtained by plain abdominal radiography and abdominal ultrasonography in the ICU may be limited by bowel gas, wounds, catheters, tissue defects, and edema 5 . Abdominal imaging with multidetector computed tomography (MDCT) has become the most accurate method to study the abdomen [6][7][8] . It can be done quickly, and some hospitals have portable CT scans in the ICU. However, the use of abdominal CTs might be limited by the risks associated with patient transfer to the CT scan suite, the high cost, limited availability, and the increased workload of hospital personnel. Moreover, two-thirds of the radiation received by patients who stay in trauma ICUs longer than 30 days is from CT scans, and radiocontrast may cause nephrotoxicity and/or severe allergic reactions 9 . Hence, physicians need to evaluate the risks and benefits before transferring a patient to a CT scan suite. This decision may be difficult in intubated patients and/or patients with polytrauma or hemodynamic compromise, especially in patients with subtle abdominal symptoms, minimal physical findings, or uncertain sites of infection.There are no randomized controlled trials to delineate how soon, how often, and how helpful CT scans of the abdomen are in clinical decision making in the ICU. Patients with intestinal ischemia can have various clinical presentations which make the diagnosis difficult. We have reviewed recent studies on the role of CT scans of the abdomen in critically ill medical patients with mesenteric ischemia to develop some suggestions for the use of these studies in the ICU.Acute mesenteric ischemia (AMI) is a life threatening abdominal emergency with mortality rates ranging from 60 to 80% [10][11][12] . Mesenteric ischemia is caused by decreased blood flow to the intestine that results in hypoxic injury and then reperfusion damage at the cellular level. These events produce mucosal injury, tissue necrosis, and metabolic acidosis; released toxic metabolites and bacterial translocation contribute to the systemic inflammatory res...

show abstract

“…In favour of this theory would be the reported consequences in young athletes after intense exercise in liver transplantation and following pancreatoduodenectomies in patients who had an unnoticed celiac trunk compression (29,30,(32)(33)(34)(35).…”

Section: Phisiopathologymentioning

confidence: 99%

The celiac axis compression syndrome (CACS): critical review in the laparoscopic era

Cienfuegos

Rotellar

Valentí

et al. 2010

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

The celiac axis compression syndrome (CACS) due to median arcuate ligament (MAL) was first described by Harjola in 1963; originating postpandrial abdominal pain, weight loss, epigastric bruit and celiac axis stenosis > 75% in angiographic studies. This clinical condition has been the origin of controversies about its pathogenesis, diagnosis and its long term clinical results. Advances in diagnostic imaging as 64 multidetector-row CT (MDCT), 3-D reconstruction, magnetic resonance (MR) and color duplex ultrasonography, provide better understanding of the syndrome and allow to identify the best candidates for surgical division of MAL fibers. Since the introduction of laparoscopic approach, and also endovascular procedures, in 2000, a new perspective has established in this challenging syndrome. With the occasion of our own experience, a critical review of the syndrome is presented.

show abstract

A Rare Cause of Mesenteric Ischemia: Celiac Axis Compression Syndrome

Abstract: Abstract

Cited by 11 publications

References 20 publications

A Review on the Celiac Trunk Compression Syndrome: Some Anatomic Clinical-Surgical Aspects

A Review on the Celiac Trunk Compression Syndrome: Some Anatomic Clinical-Surgical Aspects

The role of imaging studies in critically ill medical patients with mesenteric ischemia

The celiac axis compression syndrome (CACS): critical review in the laparoscopic era

Contact Info

Product

Resources

About