Isolated Symptomatic Celiac Artery Occlusive Disease in a Young Female: A Rare Clinical Presentation. Case Report and Literature Review
Nijmeh Hammoud1, Mariam Fadlallah1, Ali Alqattan1, Mohammed Alhunaidi1, Afak Mahmoud Alkhalil1, Ahmad Refai2, Ahmad Jafar1 and Salah Termos1*
1Department of Surgery, Amiri Hospital, MOH, Kuwait
2Department of Radiology, Amiri Hospital, Kuwait
*Corresponding Author: Salah Termos, Department of Surgery, Amiri Hospital, MOH, Kuwait.
Received: August 10, 2021; Published: August 31, 2021
Celiac artery (CA) occlusion is a relatively common finding mainly in elderly patient or due to median arcuate ligament syndrome, pancreatitis or malignancy. In the literature, no pathognomonic clinical manifestation has been reported. Most of these occlusions are asymptomatic due to rich collateral circulation from the superior mesenteric artery (SMA). A 49-year-old female patient otherwise healthy, presented with recurrent postprandial epigastric pain and mild weight loss. Initial workup including ultrasound was normal. Gastroscopy revealed the presence of a large deep ulcer, biopsy showed ischemic changes and negative for H. pylori and fungal infection. Proton pump inhibitor failed to relief her symptoms. Contrast enhanced abdominal computed tomography scan demonstrated an isolated CA stenosis with absent medial arcuate ligament syndrome. Angiography was performed demonstrating 75% celiac artery stenosis and self-expandable flexible stent was inserted. Patient had an uneventful recovery with no complaint on three years follow up.
Symptomatic CA stenosis is rare medical condition. High index of suspicion and awareness of this entity is essential for earlier diagnosis and better outcome.
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