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Multimodality Diagnosis of Mesenteric Ischemia
05:07

Multimodality Diagnosis of Mesenteric Ischemia

Published on: July 21, 2023

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Synchronous celiac artery and superior mesenteric artery compression syndrome: The effect of collateral circulation

Ulaş Aday1, Abdullah Oguz2, Hikmet Özesmer2

  • 1Department of Gastrointestinal Surgery, Dicle University School of Medicine, Diyarbakır, Turkey.

Caspian Journal of Internal Medicine
|May 24, 2023
PubMed

Insights

Laparoscopic median arcuate ligament division is effective for celiac artery and superior mesenteric artery compression when collateral circulation is sufficient. This minimally invasive approach offers clinical improvement for patients with postprandial pain and weight loss.

Area of Science:

  • Vascular Surgery
  • Gastroenterology

Background:

  • Maintaining collateral circulation is crucial in stenosis of the celiac artery (CA), superior mesenteric artery (SMA), and inferior mesenteric artery (IMA).
  • Median arcuate ligament (MAL) syndrome commonly involves SMA compression alongside CA compression, but synchronous CA and SMA compression by other ligaments is rare.

Observation:

  • A 64-year-old female presented with postprandial abdominal pain and weight loss.
  • Initial evaluation revealed synchronous compression of the CA and SMA caused by MAL.
  • The patient had sufficient collateral circulation between the CA and SMA via the superior pancreaticoduodenal artery.

Findings:

  • Laparoscopic MAL division was performed.
  • The patient experienced clinical improvement post-surgery.
  • Postoperative imaging confirmed persistent SMA compression but sufficient collateral circulation.

Implications:

  • Laparoscopic MAL division is a viable primary treatment for synchronous CA and SMA compression when collateral circulation is adequate.
  • This approach can lead to significant clinical improvement in patients presenting with relevant symptoms.
Abstract

Keywords:
Collateral circulationLaparoscopic treatment.Multilagament compression syndrome

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