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Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
07:20

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

Published on: December 21, 2012

Mysterious abdominal pain

Alberto Cappelletti1, Nicole Cristell, Monica Mazzavillani

  • 1Department of Cardiology, San Raffaele Scientific Institute, Milan, Italy.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|September 4, 2012
PubMed

Insights

Recurrent abdominal pain after coronary artery bypass grafting may signal celiac trunk stenosis. Prompt diagnosis and treatment, such as angioplasty, can resolve symptoms and improve patient outcomes.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
  • Abdominal pain can be a complex symptom with multifactorial causes.
  • Gastroepiploic artery grafts are utilized in CABG procedures.

Observation:

  • A patient with a history of CABG experienced recurrent abdominal pain.
  • Initial evaluations focused on gastrointestinal causes without resolution.
  • A positive stress test prompted further cardiac and vascular investigation.

Findings:

  • Coronary angiography revealed occluded native coronary arteries but a patent left internal mammary artery (LIMA) bypass.
  • Aortography demonstrated severe (95%) stenosis of the celiac trunk.
  • Successful angioplasty and stenting of the celiac trunk restored blood flow.

Implications:

  • Celiac trunk stenosis should be considered in patients with abdominal pain post-CABG, especially those with gastroepiploic artery grafts.
  • Vascular assessment of the celiac trunk is crucial in such cases.
  • Intervention for celiac trunk stenosis can lead to complete symptom resolution and improved quality of life.

Keywords:
Abdominal painangioplastyceliac trunkcoronary artery bypass graftingright gastroepiploic arterystent implantation

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