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Updated: Nov 30, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Celiac axis stenosis and digestive disease: Diagnosis, consequences and management
J Dembinski1, B Robert2, M-A Sevestre3
1Department of Digestive Surgery, University Hospital of Amiens Picardie et Université de Picardie Jules Verne, 1, rue du Professeur Christian Cabrol, 80054 Amiens, France; Clinical research unit SSPC (Simplifications des Soins des Patients Complexes) UR UPJV 7518, University of Picardie Jules Verne, Amiens, France.
Insights
Celiac axis stenosis, a condition affecting blood flow to upper abdominal organs, can cause significant issues in gastrointestinal procedures. Awareness and multidisciplinary management are crucial for optimal patient outcomes.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- The celiac axis (CA) and superior mesenteric artery (SMA) supply arterial blood to the upper abdomen, with interconnected pathways.
- Celiac axis stenosis can impact splanchnic circulation hemodynamics, leading to varied clinical consequences, from asymptomatic to severe ischemia.
- Management strategies for CA stenosis differ based on whether the stenosis is extrinsic or intrinsic.
Purpose of the Study:
- To highlight the importance of understanding celiac axis stenosis in the context of upper gastrointestinal interventions.
- To emphasize the multidisciplinary approach required for managing celiac axis stenosis.
- To underscore the need for awareness and adapted treatment to prevent complications.
Main Methods:
- Review of anatomical variations and hemodynamic implications of celiac axis stenosis.
- Discussion of clinical presentations and management principles for CA stenosis.
- Emphasis on the role of interventional radiologists, gastrointestinal surgeons, vascular surgeons, and physicians.
Main Results:
- Celiac axis stenosis, though relatively uncommon (5-10% prevalence), can present significant technical challenges and risks of ischemia during surgical or interventional procedures.
- Successful management requires a thorough understanding of the stenosis's nature and its impact on splanchnic circulation.
- Multidisciplinary collaboration is essential for effective planning and execution of interventions.
Conclusions:
- Surgeons, radiologists, and physicians must be aware of celiac axis stenosis due to its potential impact on upper gastrointestinal disease management.
- Proactive identification and tailored treatment of CA stenosis are vital to avoid severe complications.
- A comprehensive, multidisciplinary approach ensures optimal patient care when dealing with celiac axis stenosis.
Abstract:
Arterial blood flow to the organs of the upper abdomen is provided by the celiac axis (CA) and the superior mesenteric artery (SMA) that communicate between each other via the gastro-duodenal artery, the anterior and posterior pancreatico-duodenal arcades, the branches of the dorsal pancreatic artery and inconsistently, though a supplementary arcade that connects the CA and the SMA (arcade of Bühler). Celiac axis stenosis may or may not have a hemodynamic impact on the splanchnic circulation. Hemodynamically significant CA stenosis can be asymptomatic, or symptomatic with variables clinical consequences. Management depends on whether the mechanism of stenosis is extrinsic or intrinsic. When upper gastrointestinal interventional radiology or surgery is indicated, stenosis can pose technical difficulties or create severe ischemia requiring good understanding of this entity in the planning of operative steps and adapted management. Management of CA stenosis is therefore multidisciplinary and may involve interventional radiologists, gastrointestinal surgeons, vascular surgeons as well as medical physicians. Even though the prevalence of CA stenosis is relatively low (between 5 and 10%) and irrespective of its etiology, surgeons, radiologists and physicians must be aware of it because it can intervene in the management of upper gastrointestinal disease. It must be sought, and treatment must be adapted to each particular situation to avoid potentially severe complications.
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