Celiac Axis Compression Syndrome

Lee, Dong Shik; Kwun, Woo Hyung; Suh, Bo Yang; Kwun, Koing Bo; Kim, Yeung Jo

Abstract

External compression of the celiac artery by the median arcuate ligament of the diaphragm has been reported to result in a varient of chronic intestinal ischemia since 1963 by Harjola. Diaphragmatic compression of the celiac axis is frequently reversible and varies with respiration. The diagnosis remains one of exclusion and should be made only with very careful deliberation. Authors experienced only one case of celiac axis syndrome at Yeungnam University Hospital recently and reviewed literatures. A 29-year-old young tall and slender man complained of prolonged postprandial epigastric pain and an epigastric bruit especially during expiration for 10 years. Angiography demonstrated significant narrowing at the origin of the celiac artery. At operation, 1 cm distal portion of the celiac artery to the origin was found to be compressed by the median arcuate ligament of the diaphragm and ganglion nerve fibers, and these were divided. After division of the ligament, the blood flow through the celiac axis was increased and common hepatic artery was dilated grossly. Seven days later after surgery, abdominal pain was recurred following oral intake. So, we performed cine-angiogram of the celiac axis and found persistent the stenotic lesion, and then we performed percutaneous transluminal balloon dilatation. After this procedure, the patient has remained well and free of pain.