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Erschienen in: European Surgery 5/2016

01.10.2016 | Case Report

Celiac artery compression of patients undergoing pancreatic surgery – a case series

verfasst von: MD A. Pötscher, MD F. Längle

Erschienen in: European Surgery | Ausgabe 5/2016

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Summary

Background

Celiac artery compression due to the median arcuate ligament is a rare but not an uncommon finding in patients undergoing pancreaticoduodenectomy (PD). Due to the interruption of the collateral pathways during surgery, celiac artery compression may be associated with fatal complications.

Case reports

In this paper, we present three patients with celiac artery compression undergoing PD. In the first case, celiac artery compression was recognized during surgery, but nevertheless the patient died postoperatively because of ongoing Klebsiella sepsis. In the second case, we did not recognize it during initial surgery so further complications could have been avoided. In the third case, compression was detected during PD and the postoperative course was without complications.

Conclusion

Preoperative abdominal CT scan should be evaluated very carefully in order to identify celiac artery compression. Otherwise absence or limitation of blood flow within the common hepatic artery (CHA) during surgery should lead surgeon to suspect presence of compression of the celiac artery.
Literatur
1.
Zurück zum Zitat Muqeetadnan M, Syed A, Rahman A, Nusrat S, Hassan S. Celiac artery Compression Syndrome. Case Rep Gastrointest Med. 2013;2013:Article ID 934052. Muqeetadnan M, Syed A, Rahman A, Nusrat S, Hassan S. Celiac artery Compression Syndrome. Case Rep Gastrointest Med. 2013;2013:Article ID 934052.
2.
Zurück zum Zitat Baskan Ö, Özdenkaya Y, Cengiz E, Dolay K. Problems with the median arcuate ligament should be recognized before surgery; its importance in pancreaticoduodenectomy. Balkan Med J. 2015;32:312–5. CrossRefPubMedPubMedCentral Baskan Ö, Özdenkaya Y, Cengiz E, Dolay K. Problems with the median arcuate ligament should be recognized before surgery; its importance in pancreaticoduodenectomy. Balkan Med J. 2015;32:312–5. CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Peros G, Sakorafas GH, Giannopoulos GA, Manikis D, Vassiliu P, Brountzos EN. Successful Panreaticoduodenectomy with immediate vascular reconstrucion in a patient with cancer of the pancreatic head and celiac artery stenosis. A case report. J Pancreas. 2009;10(6):667–70. Peros G, Sakorafas GH, Giannopoulos GA, Manikis D, Vassiliu P, Brountzos EN. Successful Panreaticoduodenectomy with immediate vascular reconstrucion in a patient with cancer of the pancreatic head and celiac artery stenosis. A case report. J Pancreas. 2009;10(6):667–70.
4.
Zurück zum Zitat Horton KM, Talamini MA, Fishman EK. Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics. 2005;25(5):1177–82. CrossRefPubMed Horton KM, Talamini MA, Fishman EK. Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics. 2005;25(5):1177–82. CrossRefPubMed
6.
Zurück zum Zitat Dunbar JD, Molnar W, Beman FF, Marable SA. Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med. 1965;95(3):731–44. CrossRefPubMed Dunbar JD, Molnar W, Beman FF, Marable SA. Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med. 1965;95(3):731–44. CrossRefPubMed
7.
Zurück zum Zitat Sturiale A, Alemanno G, Giudici F, Addasi R, Bellucci F, Tonelli F. Median arcuate ligament syndrome in a patient with Crohn’s disease. Int J Surg Case Rep. 2013;4(4):399–394. CrossRefPubMedPubMedCentral Sturiale A, Alemanno G, Giudici F, Addasi R, Bellucci F, Tonelli F. Median arcuate ligament syndrome in a patient with Crohn’s disease. Int J Surg Case Rep. 2013;4(4):399–394. CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Okten RS, Kucukay F, Tola M, Bostanci B, Cumhur T. Is celiac artery compression syndrome genetically inherited? A case series from a family and review of the literature. Eur J Radiol. 2012;81(6):1089–93. CrossRefPubMed Okten RS, Kucukay F, Tola M, Bostanci B, Cumhur T. Is celiac artery compression syndrome genetically inherited? A case series from a family and review of the literature. Eur J Radiol. 2012;81(6):1089–93. CrossRefPubMed
10.
Zurück zum Zitat Bech F, Loesberg A, Rosenblum J, Glagov S, Gewertz BL. Median arcuate ligament compression syndrome in monozygotic twins. J Vasc Surg. 1994;19(5):934–8. CrossRefPubMed Bech F, Loesberg A, Rosenblum J, Glagov S, Gewertz BL. Median arcuate ligament compression syndrome in monozygotic twins. J Vasc Surg. 1994;19(5):934–8. CrossRefPubMed
11.
Zurück zum Zitat Lachowska-Kotowska P, Prystupa A, Kurys-Denis E, Kęsik JJ, Opielak G, Kupis Z, Krupski W, Zubilewicz T, Maciejewski R, Mosiewicz J. Chronic abdominal pain caused by stenosis of celiac trunk – case report. J Preclin Clin Res. 2010;4(2):168–70. Lachowska-Kotowska P, Prystupa A, Kurys-Denis E, Kęsik JJ, Opielak G, Kupis Z, Krupski W, Zubilewicz T, Maciejewski R, Mosiewicz J. Chronic abdominal pain caused by stenosis of celiac trunk – case report. J Preclin Clin Res. 2010;4(2):168–70.
13.
Zurück zum Zitat Gruber H, Loizides A, Peer S, Gruber I. Ultrasound of the median arcuate ligament syndrome: a new approach to diagnosis. Med Ultrason. 2012;14:5–9. PubMed Gruber H, Loizides A, Peer S, Gruber I. Ultrasound of the median arcuate ligament syndrome: a new approach to diagnosis. Med Ultrason. 2012;14:5–9. PubMed
14.
Zurück zum Zitat Sharafuddin MJ, Olson CH, Sun S, Kresowik TF, Corson JD. Endovascular treatment of celiac and mesenteric arteries stenoses: applications and results. J Vasc Surg. 2003;38(4):692–8. CrossRefPubMed Sharafuddin MJ, Olson CH, Sun S, Kresowik TF, Corson JD. Endovascular treatment of celiac and mesenteric arteries stenoses: applications and results. J Vasc Surg. 2003;38(4):692–8. CrossRefPubMed
15.
Zurück zum Zitat Delis KT, Gloviczki P, Altuwaijri M. Median arcuate ligament syndrome: open celiac artery reconstruction and ligament division after endovascular failure. J Vasc Surg. 2007;46(4):799–802. CrossRefPubMed Delis KT, Gloviczki P, Altuwaijri M. Median arcuate ligament syndrome: open celiac artery reconstruction and ligament division after endovascular failure. J Vasc Surg. 2007;46(4):799–802. CrossRefPubMed
16.
Zurück zum Zitat Shukla PJ, Barreto SG, Kulkarni A, Nagarajan G, Fingerhut A. Vascular anomalies encountered during pancreatoduodenectomy: Do they influence outcomes? Ann Surg Oncol. 2010;17:186–93. CrossRefPubMed Shukla PJ, Barreto SG, Kulkarni A, Nagarajan G, Fingerhut A. Vascular anomalies encountered during pancreatoduodenectomy: Do they influence outcomes? Ann Surg Oncol. 2010;17:186–93. CrossRefPubMed
17.
Zurück zum Zitat Song S‑Y, Chung JW, Kwon JW, Joh JH, Shin SJ, Kim HB, Park JH. Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation. Radiographics. 2002;22:881–93. CrossRefPubMed Song S‑Y, Chung JW, Kwon JW, Joh JH, Shin SJ, Kim HB, Park JH. Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation. Radiographics. 2002;22:881–93. CrossRefPubMed
Metadaten
Titel
Celiac artery compression of patients undergoing pancreatic surgery – a case series
verfasst von
MD A. Pötscher
MD F. Längle
Publikationsdatum
01.10.2016
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 5/2016
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-016-0443-z