Nutcracker Phenomenon as a Result of Celiomesenteric Trunk Aneurysm

Szczerepa, David; Gallagher, Margaret; Fluss, Gabriella; Trocha, Kaspar; Finlay, David

doi:10.1016/j.avsg.2021.07.043

Cited by 2 publications

(5 citation statements)

References 20 publications

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“…Similarly, Al-Zoubi et al documented a case of a 14-year-old boy presenting with chronic painless hematuria found to have nutcracker syndrome with an acute angle formed by a CMT anomaly [ 23 ]. Interestingly, an aneurysmal change of a CMT has also been described as causing this phenomenon [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Surgical Implications of Non-occlusive Mesenteric Ischemic Ileus Associated With Common Celiacomesenteric Trunk: A Case Report and Literature Review

Choi,

Pradhan,

Thite

et al. 2024

Cureus

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The celiacomesenteric trunk (CMT), an exceedingly rare anatomic variant uniting the celiac artery and superior mesenteric artery (SMA), holds significant clinical and surgical implications. Despite its rarity, understanding these implications is crucial for effective management. This report outlines the case of a 99-year-old female presenting with septic shock and abdominal pain, with imaging revealing an incidental CMT. This paper aims to elucidate the surgical implications associated with CMT through a comprehensive case review and literature search. A 99-year-old female with multiple cardiovascular comorbidities presented with altered mental status and right lower quadrant abdominal pain. Upon arrival, the patient exhibited disorientation, an inability to follow commands, hypoxia, and hypotension. Significant laboratory findings included a white count of 20.6 x 10 9 /L, lactate of 6.1 mmol/L, glucose of 53 mg/dL, alanine transaminase (ALT)/aspartate aminotransferase (AST) of 186/336 U/L, and creatinine of 4.2 mg/dL. Immediate interventions involved high-flow oxygen, fluid resuscitation, intravenous antibiotics, and admission to the ICU for septic shock. A CT angiogram (CTA) revealed an incidental large common trunk comprising the celiac trunk and superior mesenteric artery (SMA). There was a high-grade stenosis at the origin of the SMA. However, all the vessels were widely patent distally, and acute mesenteric occlusion was ruled out. By day 12, the patient achieved clinical stability after conservative management and was discharged. Complications such as aneurysm, dissection, stenosis, thrombosis, or acute occlusion of a CMT may necessitate complex surgical interventions, including endovascular procedures or open hepatic surgery. Understanding these technical complexities is vital for avoiding surgical complications in critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Diagnostic and Surgical Implications of Non-occlusive Mesenteric Ischemic Ileus Associated With Common Celiacomesenteric Trunk: A Case Report and Literature Review

Choi,

Pradhan,

Thite

et al. 2024

Cureus

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“…Our literature review on CMT-related aneurysms revealed 21 case reports, including 29 patients (Table I) [ 3 - 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Four patients underwent endovascular repair [ 3 ], while the rest had an open repair [ 4 - 20 ]. The typical open reconstruction included aneurysmectomy with vascular reconstruction in 20 [ 5 - 6 , 9 - 11 , 13 - 20 ] aneurysmorrhaphy only in two [ 8 , 12 ] aneurysmorrhaphy with great saphenous vein patch in two patients [ 4 ] and Dacron patch in one patient [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Our literature review on CMT-related aneurysms revealed 21 case reports, including 29 patients (Table I) [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Four patients underwent endovascular repair [3], while the rest had an open repair [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. The typical open reconstruction included aneurysmectomy with vascular reconstruction in 20 [5][6][9][10][11][13][14][15][16][17][18][19][20] aneurysmorrhaphy only in two…”

Section: Discussionmentioning

confidence: 99%

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Repair of Celiomesenteric Trunk Aneurysm and Review of the Literature

Lanka¹,

Sandhu²,

Farres³

et al. 2023

Cureus

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A celiomesenteric trunk (CMT) is a rare anatomic variant of a common origin for the celiac and superior mesenteric arteries. It is further a seldom occurrence to have aneurysmal dilatation of the CMT. Herein, we describe a patient with a CMT aneurysm and his open surgical repair. The open surgical repair included debranching from the right external iliac artery to the splenic and common origin of the superior mesenteric and common hepatic arteries using a bifurcated knitted graft. Postoperative recovery was unremarkable, and follow-up imaging demonstrated an excluded CMT aneurysm with excellent blood flow to the intra-abdominal organs through the bifurcated graft.

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Nutcracker Phenomenon as a Result of Celiomesenteric Trunk Aneurysm

Cited by 2 publications

References 20 publications

Diagnostic and Surgical Implications of Non-occlusive Mesenteric Ischemic Ileus Associated With Common Celiacomesenteric Trunk: A Case Report and Literature Review

Diagnostic and Surgical Implications of Non-occlusive Mesenteric Ischemic Ileus Associated With Common Celiacomesenteric Trunk: A Case Report and Literature Review

Repair of Celiomesenteric Trunk Aneurysm and Review of the Literature

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