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Society for Vascular Surgery| Volume 72, ISSUE 6, P849-863, December 1972

The celiac artery compression syndrome: Does it exist?

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      Abstract

      The contention, held by many, that association of an angiographically demonstrable stenosis of the celiac artery and a somewhat ill-defined set of clinical symptoms resembling intestinal angina constitutes a syndrome amenable to surgical correction is puzzling, since all fundamental physiologic and pathologic considerations would dictate that an isolated stenosis or even occlusion of the celiac artery should be semeiotically silent and clinically unimportant. Upon analyzing our clinical material during the last five-year period, we found no fully documented case of this syndrome. Of 157 celiac arteriograms performed both in search of cause for vague abdominal symptoms and in the study of suspected abdominal diseases, 49.7 percent of the patients showed some degree of stenosis of the celiac axis, with a considerable range of variations in anatomical detail. No correlation could be found between the existence of celiac arterial narrowing, degree of narrowing, and presence of collaterals on the one hand and such symptoms and signs as abdominal pain and weight loss on the other. The conclusion is that narrowing of the celiac artery is of such common occurrence as to be a normal anatomical variant; its association with symptoms at present has no proved significance in the pathophysiology of the alimentary tract.
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      References

        • Appleby L.H.
        The coeliac axis in the expansion of the operation for gastric carcinoma.
        Cancer. 1953; 6: 704
        • Bergan J.J.
        • Dry L.
        • Conn J.
        • Trippel O.H.
        Intestinal ischemic syndromes.
        Ann. Surg. 1969; 169: 120
        • Bobbio A.
        La sindrome del canale aortico del diaframma: stenosi da compressione del tronco celiaco.
        Omnia Med. 1968; 46: 595
        • Bron K.M.
        • Redman H.C.
        Splanchnic artery stenosis and occlusion: Incidence, arteriographic, and clinical manifestations.
        Rad. 1969; 92: 323
        • Broussin J.
        • Caille J.M.
        • Basseau P.H.
        • Diard G.F.
        • Bellet M.
        Syndrome d'oblitération du tronc coeliaque par ligament arque.
        J. Radiol. Electrol. Med. Nucl. 1970; 51: 826
        • Carey J.P.
        • Stemmer E.A.
        • Connolly J.E.
        Median arcuate ligament syndrome.
        Arch. Surg. 1969; 99: 441
      1. Celiac artery stenosis: Case presentation.
        Ill. Med. J. 1969; 135: 34
        • Charrette E.P.
        • Iyengar S.R.K.
        • Lynn R.B.
        • Paloschi G.B.
        • West R.O.
        Abdominal pain associated with celiac artery compression.
        Surg. Gynecol. Obstet. 1971; 132: 1009
        • Clarke J.S.
        Hepatic necrosis following celiac artery ligation during gastric resection in man.
        Arch. Surg. 1955; 71: 171
        • Cleator I.G.M.
        • Macpherson A.I.S.
        • Fraser J.R.
        Coeliac artery compression.
        J. R. Coll. Surg. Edinb. 1971; 16: 96
        • Colapinto R.F.
        • McLoughlin M.J.
        • Weisbrod G.L.
        The routine lateral aortogram and the celiac compression syndrome.
        Radiology. 1972; 103: 557
        • Cormier J.M.
        • de la Fontaine P.
        Sténose extrinseque du tronc coeliaque.
        Chirurgie. 1970; 96: 32
        • Derrick J.R.
        • Pollard H.S.
        • Moore R.M.
        The pattern of arteriosclerotic narrowing of the iliac and mesenteric arteries.
        Ann. Surg. 1959; 146: 684
        • Deutsch V.
        Compression of the coeliac trunk and the angiographic evaluation of its hemodynamic significance.
        Clin. Radiol. 1968; 19: 309
        • Drapanas T.
        • Bron K.M.
        Stenosis of the celiac artery.
        Ann. Surg. 1966; 164: 1085
        • Dunbar J.D.
        • Molnar W.
        • Beman F.F.
        • Marable S.A.
        Compression of the celiac trunk and abdominal angina: Preliminary report of 15 cases.
        Am. J. Roentgenol. Radium Ther. Nucl. Med. 1965; 95: 731
        • Edwards A.J.
        • Hamilton J.D.
        • Nichol W.D.
        • Taylor G.W.
        • Dawson A.M.
        Experience with coeliac axis compression syndrome.
        Br. Med. J. 1970; 1: 342
        • Fadhli H.A.
        Congenital diaphragmatic obstruction of the aorta and the celiac artery: A new clinical entity.
        J. Thorac. Cardiovasc. Surg. 1968; 55: 431
        • Gautier R.
        • Barrie J.
        • Sarrazin R.
        Les angors abdominaux non athéromateux: à propos de deux cas.
        Lyon Chir. 1965; 61: 893
        • Harjola P.-T.
        A rare obstruction of the coeliac artery.
        Ann. Chir. Gynaecol. Fenn. 1963; 52: 547
        • Harjola P.-T.
        • Lahtiharju A.
        Celiac axis syndrome: Abdominal angina caused by external compression of the celiac artery.
        Am. J. Surg. 1968; 115: 864
        • Hivet M.
        • Lagadec B.
        • Poilleux J.
        Les sténoses chroniques du tronc coeliaque.
        Chirurgie. 1970; 96: 483
        • Houdard C.
        • Carles J.-F.
        • Helenon C.
        • Boschet P.
        À propos d'un ras de compression extrinsèque du tronc coeliaque.
        J. Chir. 1970; 99: 19
        • Jamieson A.
        • Grieg J.H.
        Isolated celiac axis compression as a cause of visceral angina.
        Can. Med. Assoc. J. 1970; 103: 374
        • Klink D.D.
        Celiac axis compression syndrome.
        Wis. Med. J. 1970; 69 (moderator): 133
        • Koikkalainen K.
        Collateral circulation after gradual occlusion of the coeliac and mesenteric arteries: An experimental study.
        Ann. Chir. Gynaecol. Fenn. 1971; 60: 31
        • Koikkalainen K.
        Haemodynamically significant stenosis in the coeliac and superior mesenteric arteries.
        Ann. Chir. Gynaecol. Fenn. 1971; 60: 25
        • Koikkalainen K.
        • Kohler R.
        Stenosis and occlusion in the coeliac and mesenteric arteries.
        Ann. Chir. Gynaecol. Fenn. 1971; 60: 9
        • Koikkalainen K.
        • Harjola P.-T.
        • Laustela E.
        • Teppo L.
        Functional and morphologic effects of coeliac axis compression or the affected organs: An experimental study.
        Ann. Chir. Gynaecol. Fenn. 1968; 57: 239
        • Lindner H.H.
        • Kemprud E.
        A clinico-anatomical study of the arcuate ligament of the diaphragm.
        Arch. Surg. 1971; 103: 600
        • Lord R.S.
        • Stoney R.J.
        • Wylie E.J.
        Coeliae-axis compression.
        Lancet. 1968; 2: 795
        • Marable S.A.
        • Kaplan M.F.
        • Beman F.M.
        • Molnar W.
        Celiac compression syndrome.
        Am. J. Surg. 1968; 115: 97
        • Meaney T.F.
        • Kistner R.L.
        Evaluation of intra-abdominal disease of obscure cause. Analysis of arteriograms of 185 patients.
        Arch. Surg. 1967; 94: 811
        • Michels N.A.
        Collateral arterial pathways to the liver after ligation of the hepatic artery and removal of the celiac axis.
        Cancer. 1953; 6: 708
        • Olivier C.
        • Rettori R.
        • Di Maria G.
        Sténoses non athéromateuses et compressions du tronc coeliaque.
        Chirug. 1970; 96: 471
        • Rubush J.L.
        Celiac axis compression syndrome.
        Rev. Surg. 1970; 27: 215
        • Snyder M.A.
        • Mahoney E.B.
        • Rob C.G.
        Symptomatic celiae artery stenosis due to constriction by the neurofibrous tissue of the celiac ganglion.
        Surgery. 1967; 61: 372
        • Stanley J.C.
        • Fry W.J.
        Median arcuate ligament syndrome.
        Arch. Surg. 1971; 103: 252
        • Stewart H.R.
        Celiac steal syndrome: Possible cause of intestinal angina.
        Tex. Med. 1967; 63: 63
        • Taheri S.A.
        Abdominal pain due to isolated narrowing of the celiac artery.
        Vasc. Dis. 1968; 5: 90
        • Terpstra J.L.
        Intestinal angina secondary to compression of the coeliac axis.
        Arch. Chir. Neerl. 1966; 18: 245
        • Trede M.
        • Vollmar J.
        Das chronische Verschlusssyndrom der Eingeweideschlagadern.
        Chirurg. 1969; 40: 441
        • Vollmer J.
        • Hartert H.
        • Haase H.M.
        • Schroder K.
        • Coerper H.G.
        Das chronische Verschluss-Syndrom der Eingeweide-Schlagadern (A. coeliaca, A mesenterica superior et inferior).
        Langenbecks Arch. Chir. 1964; 305: 473