Pozzo-Salvatierra BL, Kimura-Fujikami K

Language: Spanish
References: 15
Page: 171-175
PDF size: 549.70 Kb.

ABSTRACT

Background: median arcuate ligament syndrome is a rare condition that causes abdominal angina; detecting it is a diagnostic challenge. For years, angiography was considered the only method of obtaining anatomic information for diagnosis; however, advances in tomographic techniques of multiplanar reconstruction and 3D volume rendering have made this non-invasive method a means for precise detection of this condition. Presentation of the case: female patient, 55 years of age, with history of chronic postprandial abdominal pain, associated with hyporexia, weight loss, and episodes of intermittent diarrhea. Computed tomography images clearly showed an area of anterior focal compression at the origin of the celiac trunk, with dilation of the distal segment to stenosis and collateral conduit vessels. Discussion: angiotomography plays a very important part in diagnosis of median arcuate ligament syndrome; its symptoms are potentially reversible by means of surgical treatment and detection is of vital importance in patients identified as candidates for surgery who require supra-selective arterial catheterization or liver transplant.

REFERENCES

1. Harjola PT. A rare obstruction of the coeliac artery. Ann Chir Gynaecol Fenn 1963;52:547–550.

2. Dunbar JD, Molnar W, Beman FF, et al. Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med 1965;95:731-44.

3. Colapinto RF, McLoughlin MJ, Weisbrod GL. The routine la- teral aortogram and the celiac compression syndrome. Radiology 1972;103:557-63.

4. Dunbar JD, Molnar W, Beman FF, Marable SA. Compression of the celiac trunk and abdominal angina: preliminary report of 15 cases. Am J Roentgenol 1966;95:731-744.

5. Reilly LM, Ammar AD, Stoney RJ, Ehrenfeld WK. Late results following operative repair for celiac artery compression syndrome. J Vasc Surg 1985;2:79-91.

6. Sproat IA, Pozniak MA, Kennell TW. US case of the day: median arcuate ligament syndrome. RadioGraphics 1993;13:1400–1402.

7. Patten RM, Coldwell DM, Ben-Menachem Y. Ligamentous compression of the celiac axis: CT findings in five patients. Am J Roentgenol 1991;156:1101-3.

8. Horton KM, Talamini MA, Fishman EK. Median arcuate ligament syndrome: Evaluation with CT angiography. Radiographics 2005;25:1177–82.

9. Meilán Martínez A, Jiménez de la Peña M, Recio Rodríguez M and Carrascoso Arranz J: Síndrome del ligamento mediano arcuato: una entidad controvertida. Radiología 2009;51(2):204–207.

10. Song SY, Chung JW, Kwon JW, Joh JH, Shin SJ, Kim HB, et al. Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation. RadioGraphics 2002;22(4):881–93.

11. Chou SQH, Kwok KY, Wong LS, et al, Imaging Features of Median Arcuate Ligament Syndrome. J Hong Kong Col Radiol 2010;13:101-3.

12. Levin DC, Baltaxe HA. High incidence of celiac axis narrowing in asymptomatic individuals. Am J Roentgenol 1972;116:426-9.

13. Duffy AJ, Panait L, Eisenberg D, Bell RL, Roberts KE, Sumpio B. Management of median arcuate ligament syndrome: A new paradigm. Ann Vasc Surg 2009;23:778–84.

14. Tulloch AW, Jimenez JC, Lawrence PF, Dutson EP, Moore WS, Rigberg DA, et al. Laparoscopic vs open celiac ganglionectomy in patients with median arcuate ligament syndrome. J Vasc Surg 2010;52(5):1283-1289.

15. Vilatobá M, Zamora-Valdés D, Guerrero-Hernández M, et al.: Early-onset hepatic artery thrombosis due to celiac compression. Annals of Hepatology 2011;10(1): 88-92.