Celiac compression syndrome

Marable, Samuel A.; Kaplan, Michael F.; Beman, Floyd M.; Molnar, William

doi:10.1016/0002-9610(68)90135-9

Cited by 46 publications

(18 citation statements)

References 8 publications

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“…However, with the exception of 1 patient in the OG group who developed late thrombosis of her celiac stent, all patients with recurrent symptoms in both groups had less severe pain than at their initial presentation, and all had radiographic evidence of a widely patent CA postoperatively. This finding is more consistent with the pathophysiologic mechanism of neurogenic etiology favored by some authors, 6,7 and may be another reason to avoid routine CA revascularization in patients undergoing MAL division. This finding also conflicts with the findings in Reilly et al's 3 article in which the majority of patients with recurrent abdominal pain were found to have a stenosed or occluded CA.…”

Section: Discussionsupporting

confidence: 86%

Laparoscopic versus open celiac ganglionectomy in patients with median arcuate ligament syndrome

Tulloch

Jiménez

Lawrence

et al. 2010

Journal of Vascular Surgery

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Both laparoscopic and open MAL division and celiac ganglionectomy can be safely performed with minimal patient morbidity and mortality. Late recurrence is frequently seen; however, this seems to be milder than the presenting symptoms. The laparoscopic approach results in avoidance of laparotomy and was associated with shorter inpatient hospitalization and decreased time to feeding in our study. Optimal patient selection and prediction of clinical response in these patients remains a challenge.

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Section: Discussionsupporting

confidence: 86%

Laparoscopic versus open celiac ganglionectomy in patients with median arcuate ligament syndrome

Tulloch

Jiménez

Lawrence

et al. 2010

Journal of Vascular Surgery

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“…Preceding studies have not identified any features of the clinical presentation that correlate with immediate or sustained symptom relief following op-* Rcfcrenccs 5,6,9,15,16,20,21,35. erative rcpair, ts'~7 In the present group of patients, however, long-term clinical improvcmcnt was more likely to occur in female patients who had a postprandial pain pattern and a weight loss of 20 pounds or more (Table VIII). If the patients wcrc older than 60 years, had atypical pain associated with long periods of symptom remission, and weight loss of less than 20 pounds, the likelihood of benefit from surg e u was considerably less (Table VIII).…”

Section: Discussionmentioning

confidence: 99%

Late results following operative repair for celiac artery compression syndrome

Reilly,

Ammar,

Stoney

et al. 1985

Journal of Vascular Surgery

211

139

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The clinical significance of celiac artery compression by the median arcuate ligament of the diaphragm remains unsettled. The controversy stems from an undefined pathophysiologic mechanism and the existence of celiac compression in asymptomatic patients. This study was therefore conducted to evaluate the late results of operative therapy among our patients and possibly to identify parameters that might correlate with sustained symptom relief. Among 51 patients (12 men and 39 women) (mean age 47 years) who underwent operative treatment for symptomatic celiac artery compression, 44 (86%) were available for late follow-up. Their clinical status was determined between 1 and 18 years postoperatively (mean 9.0 years) by patient interview (36) or chart review (7). Operative treatment consisted of celiac axis decompression only (16 patients), celiac decompression and dilatation (17 patients), or celiac decompression and reconstruction by primary reanastomosis or interposition grafting (18 patients). Sustained symptom relief occurred more often with a postprandial pain pattern (81% cure), age between 40 and 60 years (77%), and weight loss of 20 pounds or more (67%). A negative correlation with clinical improvement was demonstrated for an atypical pain pattern with periods of remission (43% cure), a history of psychiatric disorder or alcohol abuse (40%), age greater than 60 years (40%), and weight loss of less than 20 pounds (53%). Eight of 15 patients (53%) treated by celiac decompression alone remained asymptomatic at late follow-up in contrast to 22 of 29 patients (76%) treated by celiac decompression plus some form of celiac revascularization. Late follow-up arteriograms (18 studies) showed a widely patent celiac artery in 70% of asymptomatic patients but a stenosed or occluded celiac axis in 75% of symptomatic patients. These findings suggest that persistent clinical improvement in patients with symptomatic celiac axis compression can be achieved by an operative technique that ensures celiac axis patency. Although some clinical features are identified that correlate with long-term benefit, reliable diagnosis of the symptomatic patient awaits definition of the pathophysiologic mechanisms involved in this syndrome.

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“…These reports were soon followed by a number of publications from various institutions around the world that documented variable but for the most part successful outcomes after treating this problem with decompression of the CA and correction of any intrinsic stenosis in the vessel when indicated. [3][4][5][6][7][8][9][10][11][12] The principle source of skepticism about CACS can be traced primarily to a publication in 1972 by a preeminent vascular surgeon of the time, D. Emerick Szilagyi, 13 as well as one by Brandt and Boley 14 published in 1978. The authors of these articles conceded that the bulk of the published literature reported largely successful outcomes with treating CA compression, and they introduced no meaningful data of their own to refute the diagnosis, yet they forcefully argued against the concept of CACS.…”

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confidence: 99%