Acta Scientific Gastrointestinal Disorders (ISSN: 2582-1091)

Case ReportVolume 4 Issue 9

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

Citation: Salah Termos., et al. “Isolated Symptomatic Celiac Artery Occlusive Disease in a Young Female: A Rare Clinical Presentation. Case Report and Literature Review". Acta Scientific Gastrointestinal Disorders 4.9 (2021): 85-91.

Abstract

  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.

Bibliography

  1. Farma JM and Hoffman JP. “Nonneoplastic celiac axis occlusion in patients undergoing pancreaticoduodenectomy”. The American Journal of Surgery 193 (2007): 341-344.
  2. Prabhakar D., et al. “Celiac Axis Compression Syndrome: A syndrome of Delayed Diagnosis?” Gastroenterology and Hepatology 13 (2017): 192-194.
  3. Bacalbasa N and Balescu I. “Brasoveanu Celiac trunk stenosis treated by resection and splenic patch reconstruction. A case report and literature review”. In vivo 32 (2018): 699-702.
  4. Park CM., et al. “Celiac axis stenosis: incidence and etiologies in asymptomatic Individuals”. Korean Journal of Radiology 2 (2001): 8-13.
  5. Usah Khrucharoen., et al. “Factors associated with symptomatology of celiac artery compression and outcomes following Median arcuate ligament release”. Annals of Vascular Surgery 62 (2020): 248-257.
  6. Termos S., et al. “Segmental arterial mediolysis with 5 splenic artery aneurysms. A rare finding of a rare disease: Case report and literature review”. International Journal of Surgery Case Reports 33 (2017): 158-162.
  7. Salah Termos., et al. “Surgical Management of Hepatobiliary Complications in Sickle Cell Disease. Literature Review". Acta Scientific Gastrointestinal Disorders7 (2021): 64-71.
  8. Al-Jafar H., et al. “Etiology Based Sickle Cell Disease Hepatopathy”. Open Journal of Gastroenterology 10 (2020): 187-201.
  9. Termos S., et al. “Total Gastric Necrosis Due to Mucormycosis: A Rare Case of Gastric Perforation”. American Journal of Case Reports 19 (2018): 527-533.
  10. Kirkpatrick ID., et al. “Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: initial experience”. Radiology1 (2003): 91-98.
  11. Song SY., et al. “Collateral pathways in patients with celiac axis stenosis: Angiographic-spiral CT correlation”. Radiographics 22 (2002): 881-893.
  12. Kazan V., et al. “Celiac artery compression syndrome: A radiological finding without clinical symptoms?” Vascular 21 (2013): 293-299.
  13. Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center and Clinical Research Institute, Seoul National University Hospital, 28 Yongon-Dong, Chongno-Gu, Seoul 110-744.
  14. Nikolaos L Kelekis., et al. “Acute occlusion of the celiac axis and its branches with perforation of gastric fundus and splenic infarction, findings on spiral computed tomography”. Cases Journal 3 (2010): 82.
  15. Thomas Rettenbacher., et al. “Adult Celiac Disease: US Signs, Radiological society of north America 211 (1999): 405-410.
  16. Moneta GL., et al. “Duplex ultrasound criteria for diagnosis of splanchnic artery stenosis or occlusion”. Journal of Vascular Surgery 14 (1991): 780-788.
  17. Wiesner W., et al. “CT of acute bowel ischemia”. Radiology 226 (2003): 635-665.
  18. Kirkpatrick ID., et al. “Biphasic CT with mesenteric CT angiography in the evaluation of acute mesenteric ischemia: Initial experience”. Radiology 229 (2003): 91-98.
  19. Dokmak S., et al. “The recipient celiac trunk as an alternative to the native hepatic artery for arterial reconstruction in adult liver transplantation”. Liver Transplantation9 (2015): 1133-1141.
  20. Jimenez JC., et al. “Open and laparoscopic treatment of median arcurate ligament syndrome”. Journal of Vascular Surgery 56 (2012): 869-873.
  21. Trowell J E and Bell G. “Influence of complete revascularization”. The American Journal of Surgery 164 (2002): 220-224.
  22. Juan Carlos Jimenez. “Michael Harlander-Locke open and laparoscopic treatment of MAL syndrome”. Journal of Vascular Surgery3 (2012): 869-873.
  23. Ahanchi SS., et al. “Comparative analysis of celiac versus mesenteric artery outcomes after angioplasty and stenting”. Journal of Vascular Surgery4 (2013): 1062-1066.

Copyright: © Salah Termos., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



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