Intermittent Severe Epigastric Pain and Abdominal Bruit Varying With Respiration

Matsuura, Hiroki; Okita, Atsushi; Suganami, Yu

doi:10.1053/j.gastro.2019.09.022

Cited by 4 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is estimated that in 10% to 24% of the general population, the median arcuate ligament crosses anterior to the celiac artery, however only a fraction of these patients experience abdominal pain [ 5 , 6 ]. This may be explained in part by the rich collateral blood supply provided by the branches of the superior mesenteric artery [ 2 , 5 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Post-prandial pain is thought to result from intestinal angina, or increased intestinal oxygen demand that cannot be met due to celiac artery stenosis. However, it is important to note that only 40% of patients with this disorder present with intestinal angina, likely due to sufficient collateral blood supply to the affected region [ 3 , 5 , 9 ]. Therefore, it is theorized that those without a sufficient collateral blood supply may present with clinical symptoms.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Celiac Artery Compression Syndrome: A Unique Presentation

Ali

Kazmi

Barajas-Ochoa

et al. 2021

Cureus

View full text Add to dashboard Cite

Celiac artery compression syndrome (CACS), also known as median arcuate ligament syndrome, celiac axis syndrome, and Dunbar Syndrome, is a rare disorder that results from compression of the celiac artery by the median arcuate ligament. The following is a case that depicts an interesting presentation of a patient diagnosed with this rare condition. A 44-year-old male with a history of mutism was brought in by his family for weight loss of 100 lbs with intermittent abdominal pain, weakness and lethargy over a period of five years. His family reported that he had poor nutritional intake, and could only eat a small amount before he seemed to be in pain, and eventually refused to eat. He had no other prior medical history except for mutism, no family history of malignancy, no history of trauma, surgeries, smoking or substance use, and did not take any medications. Physical exam was largely unremarkable. Mesenteric vascular duplex demonstrated severe grade stenosis of the celiac trunk with post-stenotic velocity of 520 cm/sec. Contrast enhanced computed tomography angiography revealed acute angle J-configuration of the takeoff of the celiac axis, with stenosis at its origin and focal post-stenotic dilatation, confirming the diagnosis of CACS.CACS is an elusive diagnosis that should be considered in patients where other causes of abdominal pain and weight loss have been ruled out. The disease can present with the classic triad of post-prandial abdominal pain, weight loss, and an abdominal bruit. Imaging modalities including mesenteric vascular duplex, computed tomography abdominal angiography, magnetic resonance angiography and celiac artery angiography can help make the diagnosis. Treatment involves surgical decompression via division of the median arcuate ligament, with most patients experiencing significant and long-lasting relief from their symptoms.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Celiac Artery Compression Syndrome: A Unique Presentation

Ali

Kazmi

Barajas-Ochoa

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…In our case, a robot-assisted technique was preferred to avoid the limitations of video endoscopy [ 15 ]. After surgical intervention, clinical improvements have been reported in 65% to 80% of CACS patients [ 16 ], and, as there is a recurrence risk after surgery, patients should receive serial follow-up [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Celiac Artery Compression Syndrome Presenting As Recurrent Diabetic Ketoacidosis: A Diagnostic Challenge

Salem¹,

Aly²,

Al-Aghil³

et al. 2021

Cureus

View full text Add to dashboard Cite

Celiac artery compression syndrome (CACS), also known as median arcuate ligament syndrome, can sometimes represent a diagnostic challenge. Here, we present the case of a 29-year-old man who presented with recurrent diabetic ketoacidosis (DKA), abdominal pain, and vomiting thought to be due to cyclical vomiting syndrome. However, the lack of a clear precipitant for DKA, the presence of chronic gastrointestinal symptoms, and a revealing physical examination of abdominal bruit led to clinical suspicion of CACS and its diagnosis after appropriate investigations. While angiography has traditionally been considered the gold standard diagnostic test, hemodynamic and geometric ultrasound criteria can, however, be diagnostic. The patient was managed by releasing the celiac artery through robotic surgery and serial monitoring as an outpatient revealed resolution of his symptoms and no further readmissions for DKA. This case highlights how a presumptive and erroneous diagnosis (cyclical vomiting syndrome) can misguide clinicians, especially when dealing with a rare diagnosis of exclusion.

show abstract

Multiple pancreaticoduodenal artery aneurysms and retroperitoneal bleeding in a patient with celiac artery compression syndrome

Matsuura,

Okita

2023

Intern Emerg Med

View full text Add to dashboard Cite

Intermittent Severe Epigastric Pain and Abdominal Bruit Varying With Respiration

Cited by 4 publications

References 3 publications

Celiac Artery Compression Syndrome: A Unique Presentation

Celiac Artery Compression Syndrome: A Unique Presentation

Celiac Artery Compression Syndrome Presenting As Recurrent Diabetic Ketoacidosis: A Diagnostic Challenge

Multiple pancreaticoduodenal artery aneurysms and retroperitoneal bleeding in a patient with celiac artery compression syndrome

Contact Info

Product

Resources

About