Celiac Artery Compression Syndrome After Recurrent Pancreatitis: a Case Report
Date Issued | Start Page | End Page |
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2024-04-12 | 322 | 322 |
Surgical Case Report Session
Trustee of the paper Velička Linas
Background The purpose of this case report is to review a possible condition which can cause one of a most common symptom in medical practice - abdominal pain. Celiac artery compression syndrome is not a very frequent illness but it should be considered in differential diagnostics of abdominal pain when there is no other evident cause. Whereas celiac artery compression is rare phenomenon, it can be hard for the vascular surgeon to decide what treatment option is the most suitable, thus this case report is aimed to present possible surgical treatment option with positive outcomes. Case Report A 35 years old male patient was presented to the hospital of Kaunas Clinics for abdominal pain. The patient had recurrent autoimmune pancreatitis without IgG4 elevation episodes for three years in his case-history, maintenance therapy with prednisolone was prescribed. Abdominal computed tomography (CT) scan with contrast was performed. There were no changes in pancreas and other abdominal cavity organs. However, there was a focal narrowing (subocclusion) in the celiac artery area thus demonstrating signs of cealiac artery compression by the median arcuate ligament. First decision of the vascular surgeon was to perform endovascular PTA procedure for this patient on 2024-01-19. Endovasvular celiac trunk recanalisation was unsuccessful. After 3 weeks on 2024-02-08 it was decided to operate on celiac trunk under endotracheal anesthesia. Upper laparotomy was made and decompression of diaphragmic crura performed with a short bypass from aorta to celiac trunk using 8 mm synthetic prosthesis. There were no surgery-related complications, blood loss was about 300 ml. Patient was discharged from hospital after one week in improving health condition and without abdominal pain. Conclusions Celiac artery compression syndrome should be considered in differential diagnostics of abdominal pain when there is no other evident cause. Diaphragmic crura decompression and bypass from aorta to celiac trunk formation is a proper surgery technique for celiac artery compression.