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Celiac compression syndrome

P B Ghosn, A G Rabbat, J Trudel

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |July 1, 1982
    PubMed
    Summary
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    Celiac compression syndrome, caused by median arcuate ligament, can be treated with surgical release of the celiac axis and nerve resection. This effective treatment leads to asymptomatic recovery in patients with upper abdominal pain.

    Area of Science:

    • Vascular Surgery
    • Gastroenterology
    • Surgical Gastroenterology

    Background:

    • Celiac compression syndrome, characterized by upper abdominal pain, can result from extrinsic compression of the celiac axis.
    • An epigastric bruit with a normal digestive tract may indicate extrinsic celiac axis compression.

    Purpose of the Study:

    • To evaluate the surgical treatment outcomes for celiac compression syndrome.
    • To assess the efficacy of median arcuate ligament release and periarterial neurectomy.

    Main Methods:

    • Seven patients with celiac compression syndrome underwent section of the median arcuate ligament to free the celiac axis.
    • Resection of the connecting nerve fibers of the solar plexus (periarterial neurectomy) was performed in conjunction with ligament release.
    • Lateral aortography was used to diagnose extrinsic compression in patients with epigastric bruits and normal digestive tracts.

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    Main Results:

    • All seven patients were asymptomatic at a mean follow-up of 36 months.
    • Surgical intervention successfully relieved upper abdominal pain associated with celiac compression syndrome.
    • The study highlights the importance of considering surgical intervention for persistent upper abdominal pain potentially caused by celiac axis compression.

    Conclusions:

    • Surgical release of the celiac axis combined with complete periarterial neurectomy is an effective treatment for celiac compression syndrome.
    • The findings suggest that pain in this syndrome is not solely hemodynamic and requires surgical management.
    • Median arcuate ligament release and neurectomy offer a definitive solution for patients suffering from celiac compression syndrome.