Arcuate ligament vascular compression syndrome in infants and children

Schweizer, Paul; Berger, Stephan; Schweizer, Michael T.; Schaefer, Jochen T.; Beck, Otfried

doi:10.1016/j.jpedsurg.2005.06.040

Cited by 27 publications

(16 citation statements)

References 17 publications

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“…The most commonly documented cause of celiac artery compression is due to the relationship between the celiac artery and the diaphragmatic crura, especially the interposed MAL and the suspensory ligament of Treitz (De Pauw et al, 1992;Balaban et al, 1997;Bech, 1997;Kopecky et al, 1997;Schreiber et al, 1998;Horton et al, 2005;Schweizer et al, 2005). The most common type of compression of the celiac artery has been credited to the MAL, giving this clinical issue its alternate moniker: MALS ( Figs.…”

Section: Anatomy Of the Cacsmentioning

confidence: 99%

“…Embryologically, it is still unknown what the effect of the developmental process is upon the diaphragmatic crura in relation to the MAL. This becomes clinically important due to the discovery of pediatric cases of CACS (Schweizer et al, 2005).…”

Section: Anatomy Of the Cacsmentioning

confidence: 99%

“…If the diaphragmatic crura deviate acutely relative to the abdominal aorta/vertebral column (long muscular arches) they may constrict the celiac trunk, via the MAL (Schweizer et al, 2005). The inverse must then be considered with the celiac artery deviating obtusely toward the diaphragm.…”

Section: Anatomy Of the Cacsmentioning

confidence: 99%

“…Recently, Alehan and Dogan (2004), Schweizer et al (2005) and Scholbach (2006) have reported pediatric cases of CACS. This may have implications for an embryologic origin of this disease.…”

mentioning

confidence: 99%

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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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Section: Anatomy Of the Cacsmentioning

confidence: 99%

Section: Anatomy Of the Cacsmentioning

confidence: 99%

Section: Anatomy Of the Cacsmentioning

confidence: 99%

“…Recently, Alehan and Dogan (2004), Schweizer et al (2005) and Scholbach (2006) have reported pediatric cases of CACS. This may have implications for an embryologic origin of this disease.…”

mentioning

confidence: 99%

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Clinical anatomy of celiac artery compression syndrome: A review

et al. 2007

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“…Common symptoms include post-prandial epigastric pain, nausea, vomiting, and mild weight loss. Less frequently patients experience diarrhea, heartburn, abdominal bloating, constipation, arrhythmias and syncope [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Celiac artery compression syndrome. Mini-review

Rongies-Kosmol

Jakimowicz

2015

Acta Angiologica

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A cadaveric study of the anatomical variation of the origins of the celiac trunk and the superior mesenteric artery

Katz-Summercorn

Bridger

2013

Clinical Anatomy

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Gray's Anatomy states, "the celiac trunk is the first anterior branch of the abdominal aorta and arises just below the aortic hiatus. The superior mesenteric artery originates from the aorta c1.0 cm below the celiac trunk." (Standring, 2008a, Gray's Anatomy. 40th Ed. London: Churchill Livingstone Elsevier, p. 1073-1074). During dissection classes with medical students we found this not to be the case. We have re-evaluated the anatomy of the origins of the celiac trunk (CT) and superior mesenteric artery (SMA) and the relationship of the CT to the median arcuate ligament (MAL) in 99 cadavers. We have found the external distance between the CT and SMA to range from 0 to 20 mm (mean 3.4 mm, SD 5.17 mm), with the two in direct apposition in 57.6% (n = 99) of cases: a higher figure than previously documented. However, the internal distance between the CT and SMA ranged from 10 to 30 mm (mean 18.9 mm, SD 4.09 mm). There was no distance measurable between the MAL and the CT in 88 cadavers (92.6%, n = 95) and, of these, 32 (33.7%) showed evidence of compression or kinking of the CT. We suspect that the MAL is responsible for the approximation of the CT to the SMA in these cadavers, and that the high incidence of kinking of the CT (33.7% of cases) may have implications with regard to its role in MAL syndrome.

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Arcuate ligament vascular compression syndrome in infants and children

Cited by 27 publications

References 17 publications

Clinical anatomy of celiac artery compression syndrome: A review

Clinical anatomy of celiac artery compression syndrome: A review

Celiac artery compression syndrome. Mini-review

A cadaveric study of the anatomical variation of the origins of the celiac trunk and the superior mesenteric artery

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