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Clinical anatomy of celiac artery compression syndrome: a review

Marios Loukas1, Jeremy Pinyard, Sumreen Vaid

  • 1Department of Anatomical Sciences, St. George's University, Grenada, West Indies. edsg2000@yahoo.com

Clinical Anatomy (New York, N.Y.)
|February 20, 2007
PubMed

Insights

Celiac artery compression syndrome (CACS) involves pain from median arcuate ligament or nerve plexus compression. This review explores its varied causes and diagnostic relevance in modern medicine.

Area of Science:

  • Medical Anatomy
  • Vascular Surgery
  • Gastroenterology

Background:

  • Anatomic variations can cause clinical conditions, including median arcuate ligament (MAL) compression of the celiac artery.
  • Celiac artery compression syndrome (CACS) is a controversial condition causing postprandial abdominal pain due to mesenteric ischemia.
  • Surgical decompression of the celiac artery by releasing the MAL has been explored, but persistent symptoms raise questions about its existence.

Purpose of the Study:

  • To investigate compression of the celiac artery and superior mesenteric artery by surrounding structures.
  • To review the definition, relevance, and varying etiologies of CACS.
  • To justify the clinical relevance of CACS in contemporary medical practice.

Main Methods:

  • Review of literature on CACS, focusing on anatomical causes of celiac artery compression.
  • Discussion of diagnostic advancements like angiographic MRI and color duplex ultrasonography.
  • Analysis of surgical approaches and their outcomes.

Main Results:

  • Celiac artery compression can result from various anatomical factors, including "high take off" origins, elongated diaphragmatic crura and MAL, or enlarged celiac ganglia.
  • No single cause can be identified due to diverse anatomical etiologies.
  • Technological advances are re-emphasizing the importance of considering celiac artery compression in differential diagnoses.

Conclusions:

  • CACS remains a relevant consideration in differential diagnosis, despite historical controversy.
  • Understanding the varied anatomical sources of compression is crucial for diagnosis and treatment.
  • Further investigation is needed to definitively classify and manage CACS symptoms.

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