Laparoscopic decompression of celiac trunk in children

Compression stenosis of the celiac trunk (CSCT) is a syndrome based on the celiac trunk stenosis of varying degree, sometimes in combination with that of the superior mesenteric artery, caused by the compression of this vessel by the medial arched ligament of the diaphragm, as well as its internal legs and the neurofibrotic tissue of the celiac plexus. CSCT can cause chronic ischemia of the abdominal organs and chronic pain syndrome. The branches of the celiac trunk, supplying the stomach, liver, pancreas to the blood, are connected with the mesenteric arteries of the intestine in a common circle, therefore, with a lack of blood flow along one of the branches, the entire digestive tract suffers . The main clinical manifestation of CSCT is abdominal pain, observed in 97–100% patients. Angiography is the most invasive and, at the same time, the most informative method currently available to assess the extent and degree of the celiac trunk narrowing and to determine indications for surgical treatment. Ultrasound is a harmless, painless and at the same time informative diagnostic method for CSCT. A modern ultrasound technique is ultrasound with the use of echocontrast. Multi-detector CT angiography with multiplanar and 3D reconstruction is the optimal method of X-ray diagnostics of CSCT. MR angiography is successfully used both for preoperative preparation in patients with compression of the celiac trunk, and in the postoperative period. The methods of surgical treatment for abdominal ischemia are divided into palliative, decompressional and reconstructive. Modern diagnostic methods allow non-invasive methods to diagnose CSES in combination with clinical manifestations. The laparoscopic method is optimal for celiac trunk decompression, but the choice of the surgical treatment method should be considered individually.

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Stenosis of the Celiac Trunk – From Diagnostics to Treatment

Afukova

Юдин

Разумовский

2018

Medicinskaâ vizualizaciâ

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Clinical case of median arcuate ligament syndrome in the practice of a pediatric surgeon

Surkov,

Dondup,

Piloyan

et al. 2024

Tihookeanskij medicinskij žurnal

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Recurrent abdominal pain in childhood and adolescence may be indicative of chronic mesenteric ischemia with median arcuate ligament syndrome as a result of compression of the celiac artery by the median arcuate ligament of the diaphragm and its internal crura, neurofibrous tissue of the celiac plexus. The presence of symptoms characteristic of various diseases of gastrointestinal tract organs, absence of pathognomonic signs and complex approach in diagnostics of abdominal cavity vascular system, insufficient awareness of specialists of children’s outpatient clinics determine the urgency of timely diagnostics and treatment of patients with this pathology. Median arcuate ligament syndrome, or Dunbar syndrome, is more often a congenital malformation. This syndrome can be considered as an acquired pathology in the case of compression of the celiac artery by enlarged lymph nodes and neurofibrous tissue of the celiac plexus. In addition to hemodynamically significant disorders of blood supply to the gastrointestinal tract, Dunbar syndrome in children and adolescents is also accompanied by psycho-emotional disorders due to the presence of unstable stools, recurrent abdominal pain, and often repeated ineffective requests for medical care. Clinical observation, methods of diagnosis and surgical treatment of median arcuate ligament syndrome in a 14-year-old patient are presented in the study.

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Laparoscopic decompression of celiac trunk in children

Cited by 2 publications

References 23 publications

Stenosis of the Celiac Trunk – From Diagnostics to Treatment

Stenosis of the Celiac Trunk – From Diagnostics to Treatment

Clinical case of median arcuate ligament syndrome in the practice of a pediatric surgeon

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