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[Syndrome caused by extrinsic compression of the celiac trunk (apropos of 4 cases)]

D Mongelli, P Pederzoli, G Serio

    Chirurgia Italiana
    |December 1, 1980
    PubMed

    Insights

    Surgical resection of the median arcuate ligament effectively treated extrinsic compression of the coeliac trunk, relieving abdominal pain. Long-term outcomes were excellent to good in all patients.

    Area of Science:

    • Vascular Surgery
    • Gastroenterology
    • Diagnostic Imaging

    Background:

    • Extrinsic compression of the coeliac trunk by the median arcuate ligament can cause significant abdominal pain.
    • Accurate diagnosis requires excluding other gastrointestinal, biliary, and pancreatic pathologies through comprehensive investigations.
    • Surgical intervention, specifically resection of the median arcuate ligament, is a treatment option.

    Observation:

    • Four cases (3 males, 1 female) of symptomatic extrinsic coeliac trunk compression were documented using angiography.
    • Patients presented with recurrent abdominal pain attacks.
    • One patient also required distal pancreatic resection due to concurrent chronic pancreatitis.

    Findings:

    • Surgical resection of the median arcuate ligament yielded excellent long-term results in 3 cases and good results in 1 case.
    • Preoperative biochemical and instrumental evaluations were crucial for accurate diagnosis and surgical indication.
    • The management of accompanying chronic pancreatitis was addressed in one patient.

    Implications:

    • Resection of the median arcuate ligament is a viable surgical treatment for coeliac trunk compression syndrome.
    • The study highlights the importance of thorough diagnostic workups to differentiate coeliac trunk compression from other abdominal pathologies.
    • Ongoing discussion exists regarding the optimal surgical approach, including the potential benefits of sympathectomy or coeliac ganglionectomy alongside ligament resection.

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