Celiac Artery Aneurysms: A Case Report and Review of the Literature

2006 ◽  
Vol 72 (8) ◽  
pp. 746-749 ◽  
Author(s):  
John M. Connell ◽  
David C. Han
Keyword(s):  
Abdominal Pain ◽  
Mesenteric Ischemia ◽  
Mortality Rates ◽  
Celiac Artery ◽  
Review Of The Literature ◽  
Common Cause ◽  
Male Predominance ◽  
Surgical Emergencies ◽  
Elective Repair ◽  
Vague Abdominal Pain

Celiac artery aneurysms (CAA) are uncommon. Most are asymptomatic, but up to 20 per cent will present as surgical emergencies. We present a case of an asymptomatic CAA discovered in a 56-year-old male during evaluation for nephrolithiasis. Only rough estimates of the prevalence of CAA are available, ranging between 0.005 per cent and 0.05 per cent. There appears to be a slight male predominance, and atherosclerotic degeneration is the most common cause. Although most patients are asymptomatic, some will present with vague abdominal pain, nausea, vomiting, or symptoms of mesenteric ischemia. Rupture is a devastating presentation, with reported mortality rates from 35 per cent to 80 per cent. Repair is performed by ligation or reconstruction. Ligation should be considered in an urgent setting, with reconstruction preferred for elective repair. Morbidity and mortality from elective repair should not exceed 5 per cent. Repair of CAA should be undertaken unless major comorbid factors are prohibitive.

Safety and Efficacy of Intentional Celiac Artery Coverage in Endovascular Management of Thoracoabdominal Aortic Diseases: A Systematic Review and Meta-analysis

2021 ◽  
pp. 152660282110594
Author(s):  
Christos Argyriou ◽  
Stavros Spiliopoulos ◽  
Konstantinos Katsanos ◽  
Nikolaos Papatheodorou ◽  
Miltos K. Lazarides ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Aortic Aneurysm ◽  
Mesenteric Ischemia ◽  
Meta Analysis ◽  
Spinal Cord Ischemia ◽  
Mortality Rates ◽  
Celiac Artery ◽  
Morbidity And Mortality ◽  
Endovascular Management ◽  
Safety And Efficacy

Purpose: Thoracic endovascular aortic aneurysm repair (TEVAR) has emerged as an attractive alternative option in the treatment of thoracoabdominal aortic aneurysm (TAAA) diseases, reporting lower morbidity and mortality rates compared with open or hybrid repair. A challenging situation arises when the aneurysm involves the celiac artery (CA), precluding a safe distal landing zone. We investigated the safety and efficacy of CA coverage in the treatment of complex TAAA diseases during endovascular management. Materials and Methods: A review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The electronic bibliographic sources searched were MEDLINE and SCOPUS databases. Primary outcomes of interest were perioperative and 30-day mortality. Any type of endoleak, mesenteric ischemia, perioperative spinal cord ischemia, and reintervention rates were secondary end points. A random-effects meta-analysis was performed. Summary statistics of event risks were expressed as proportions and 95% confidence interval (CI). Results: Ten observational cohort studies published between 2009 and 2020, reporting a total of 175 patients, were eligible for quantitative synthesis. Indications for TEVAR were primary TAAAs in 82% of patients, aortic dissection in 14% of patients, type Ib endoleak after previous endograft deployment in 3% of patients, and penetrating aortic ulcer in 1 patient. Reintervention rate was 9% (95% CI, 4%–20%) and spinal cord ischemia was 7% (95% CI, 4%–-12%). Type II endoleak was the predominant type of endoleak in 10% of patients (95% CI, 4%–22%), followed by type I endoleak in 5% of patients (95% CI, 2%–12%) and type III endoleak in 1% (95% CI, 0%–16%) of patients. Mesenteric ischemia occurred in 6% of patients (95% CI, 3%–10%). Thirty-day mortality was 5% (95% CI, 2%–13%) and the pooled estimate for overall mortality was 21% (95% CI, 14%–31%). Conclusions: Celiac artery coverage during TEVAR is a challenging but feasible option for the treatment of TAAA diseases, providing acceptable morbidity and mortality rates. Demonstration of adequate visceral collateral pathways before definitive CA coverage is the sine quo non for the success of the technique.

scholarly journals Abdominal Pain in the Female Patient: A Case of Concurrent Acute Appendicitis and Ruptured Endometrioma

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Martine A. Louis ◽  
Amanda R. Doubleday ◽  
Elizabeth Lin ◽  
Ji Yoon Baek ◽  
Alda Andoni ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdominal Pain ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Common Cause ◽  
Surgical Emergencies ◽  
Ovarian Endometrioma ◽  
General Surgeons

General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma.

Giant Celiac Artery Aneurysm with Associated Visceral Occlusive Disease

Vascular ◽  
2004 ◽  
Vol 12 (6) ◽  
pp. 390-393
Author(s):  
Marcus D'Ayala ◽  
Jonathan S. Deitch ◽  
John deGraft-Johnson ◽  
Eric Nguyen ◽  
Deirdre McGagh ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Clinical Practice ◽  
Unusual Case ◽  
Surgical Repair ◽  
Artery Aneurysm ◽  
Celiac Artery ◽  
Occlusive Disease ◽  
Open Surgical Repair ◽  
Celiac Artery Aneurysm ◽  
Vague Abdominal Pain

Celiac artery aneurysms are rarely seen in clinical practice. We report an unusual case of a large celiac artery aneurysm in a patient with associated visceral occlusive disease who presented with vague abdominal pain and underwent uneventful open surgical repair.

Stenting of stenotic mesenteric arteries for symptomatic chronic mesenteric ischemia

VASA ◽  
2012 ◽  
Vol 41 (6) ◽  
pp. 425-431 ◽  
Author(s):  
Aschenbach ◽  
Bergert ◽  
Kerl ◽  
Zangos ◽  
Neumeister ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Gastrointestinal Bleeding ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Lower Gastrointestinal Bleeding ◽  
Mesenteric Arteries ◽  
Chronic Mesenteric Ischemia ◽  
Technical Failure

Background: We report the results of our single center series of patients with chronic mesenteric ischemia (CMI) to determine the role of stenting in the management of patients. Patients and methods: We retrospectively reviewed all patients with CMI treated endovascularly with stent revascularisation from January 2008 to January 2011.CMI diagnosis was made according to clinical symptoms, including postprandial abdominal pain, food fear, and weight loss. Additionally, the diagnosis was confirmed by duplex ultrasonography and/or computed tomography angiography and/or contrast-enhanced magnetic resonance angiography. Results: All 45 patients presented with typical CMI symptoms: 45/45 (100 %) had postprandial pain, 31/45 (68.8 %) had a weight loss of more than 10 kilograms, and 11/45 (24.4 %) suffered from ischemic colitis combined with lower gastrointestinal bleeding. In three patients occlusion could not be crossed, therefore considered as technical failure. A total of 55 arteries were stented in the remaining 42 patients. Nineteen patients underwent SMA stenting alone, eight underwent celiac stenting, alone and three patients underwent stenting of inferior mesenteric artery (IMA) alone. We performed combined stenting of the celiac artery and superior mesenteric artery in ten patients, and one patient underwent a combined stenting of the celiac artery and the IMA. All three mesenteric arteries were stented in only one patient. Primary technical success was achieved in 42/45 (94.8 %) patients. Clinical symptom relief was achieved in 39/45 (86.6 %) patients with abdominal pain. Increased body weight was observed in 28/31 (90.3 %) patients with an average weight gain of 8.8 kilograms (5 - 12 kilograms), and 10/11 (90.9 %) patients recovered from ischaemic colitis/lower gastrointestinal bleeding. Conclusions: Stent revascularisation can be considered as the first-line therapy for patients with chronic mesenteric ischemia.

Diagnosis and Management of Nonocclusive Mesenteric Ischemia

2018 ◽  
Vol 02 (03) ◽  
pp. 240-243
Author(s):  
Himani Agarwal ◽  
Anil Pillai ◽  
Sanjeeva Kalva
Keyword(s):  
Early Diagnosis ◽  
Clinical Diagnosis ◽  
Mesenteric Ischemia ◽  
Mortality Rates ◽  
Review Of The Literature ◽  
Radiological Findings ◽  
Nonocclusive Mesenteric Ischemia ◽  
Comprehensive Review ◽  
The Past ◽  
Venous Circulation

AbstractAcute hypoperfusion of the bowel without mechanical occlusion of the arterial or venous circulation is referred to as nonocclusive mesenteric ischemia (NOMI) and is responsible for approximately one fourth of all arterial causes of mesenteric ischemia. Patients present with nonspecific symptoms, making clinical diagnosis difficult. Prognosis is poor with high mortality rates. Mortality rates have improved during the past two decades from 80 to 50% due to early diagnosis and prompt initiation of treatment. In this review, we discuss the etiology, pathophysiology, and symptoms of NOMI as well as radiological findings and management along with comprehensive review of the literature.

scholarly journals Management of Digestive Surgical Emergencies in Children in a Developing Country (Newborns Excluded)

2020 ◽  
Vol 2 (1) ◽  
pp. 19-29
Author(s):  
Mboutol-Mandavo C ◽  
Détsélé RC ◽  
Miéret JC ◽  
Akobande NE ◽  
Ondima IPL ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Descriptive Study ◽  
Common Complication ◽  
Male Predominance ◽  
Acute Peritonitis ◽  
Surgical Emergencies ◽  
Nosological Entity ◽  
The Mean ◽  
Surgery Department ◽  
Consultation Time

Aim: It was a question of determining the epidemiological, diagnostic and therapeutic aspects of the digestive surgical emergencies of the child in our environment. Patients and Methods: This is a prospective and descriptive study carried out for 12 months in the pediatric surgery department. Results: During the study period, on 668 patients admitted we retained 87 cases of digestive surgical emergencies; representing a hospital frequency of 13%. The mean age was 7.6 ± 3.5 years (range 30 days and 16 years). We noted a male predominance with 61 boys (70.1%) for 26 girls (29.9%). The taxi was the most used form of transportation in 77 cases (88.5%). The average consultation time was 5.4 days ± 5.3 days (1 hour and 21-day extremes). Abdominal pain was the main reason for consultation with 66.7% of cases. Generalized acute peritonitis was the predominant diagnosis with 32 cases (39.1%), followed by strangulated parietal hernias with 17 cases (19.5%) and acute intestinal intussusception with 11 cases (12.6%). The postoperative course was complicated in 27 cases (33.7%). parietal suppurations were the most common complication with 77.8% of cases. Six patients (6.9%) died. Conclusion: Digestive surgical emergencies represent a frequent nosological entity in our practice. Abdominal pain is the first reason for consultation. Appendicular peritonitis are the first cause of digestive surgical emergency in children in our practice. They remain a worrying problem for pediatric surgeons.

scholarly journals Percutaneous retrograde revascularization of chronic occlusions of the superior mesenteric artery via collaterals of the celiac artery

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Wilhelm H. Kersjes ◽  
Alexander Hesse
Keyword(s):  
Abdominal Pain ◽  
Clinical Outcome ◽  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Chronic Mesenteric Ischemia ◽  
Technical Success ◽  
Chronic Total Occlusions

Abstract Purpose To evaluate the technical success of percutaneous retrograde revascularization of the superior mesenteric artery (SMA) via the celiac artery (CA) in patients with chronic mesenteric ischemia (CMI). Methods We performed a retrospective review of three patients with chronic total occlusions (CTOs) of the origin of SMA which were recanalized retrograde via collaterals of the CA after frustrating attempt of antegrade revascularization from the abdominal aorta in our institute between May 2019 and June 2020. Results All technical procedures of retrograde revascularization of CTOs of SMA via collaterals of the CA were successful. The clinical outcome resulted in a sustained resolution of abdominal pain in all cases. Conclusion Retrograde recanalization of SMA via collaterals from the CA seems to be a successful endovascular option for patients with CMI and a chronically occluded superior mesenteric artery when antegrade recanalization fails as far as it can be concluded from the small number of presented cases.

Chronic Mesenteric Ischemia after Partial Coverage of the Celiac Artery during TEVAR, Case Report, and Review of the Literature

2014 ◽  
Vol 28 (8) ◽  
pp. 1935.e1-1935.e6 ◽  
Author(s):  
Micheal Ayad ◽  
Zachary J. Senders ◽  
Sean Ryan ◽  
Babak Abai ◽  
Paul DiMuzio ◽  
...  
Keyword(s):  
Case Report ◽  
Mesenteric Ischemia ◽  
Celiac Artery ◽  
Chronic Mesenteric Ischemia ◽  
Review Of The Literature ◽  
Partial Coverage

scholarly journals Isolated Celiac and Splenic Artery Dissection: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Tania Moussa ◽  
Georges Nawfal ◽  
Tarek Assi ◽  
Elie El Rassy ◽  
Elie Massoud ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Splenic Artery ◽  
Unusual Case ◽  
Case Analysis ◽  
Rare Condition ◽  
Management Plan ◽  
Celiac Artery ◽  
Artery Dissection ◽  
Review Of The Literature ◽  
High Level

An isolated dissection of the celiac artery is an extremely rare condition that requires a high level of suspicion to evoke the diagnosis. Once established, the natural course is unpredictable in view of the discrepancies in its management requiring a case-by-case analysis. In this paper, we report an unusual case of spontaneous abdominal pain that was diagnosed with celiac and splenic artery rupture secondary to physical stress. This paper underlines the necessity to maintain a high level of suspicion for arterial dissections and we also review the management plan in such cases.

Intra-abdominal Inferior Vena Cava Injuries: Operative Strategies and Outcomes

2020 ◽  
pp. 000313482097339
Author(s):  
Christine A. Castater ◽  
Margo Carlin ◽  
Virginia D. Parker ◽  
Chris Sciarretta ◽  
Deepika Koganti ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Mortality Rates ◽  
Volume Resuscitation ◽  
Vascular Injuries ◽  
Trauma Centers ◽  
Review Of The Literature ◽  
Hemorrhage Control ◽  
Operative Strategies

Visceral vascular injuries are relatively uncommon even in busy urban trauma centers. The inferior vena cava (IVC) is the most frequently injured visceral vein and can be a complex operative challenge. Despite advances in early volume resuscitation, improved transport times, prompt operative intervention, and hemorrhage control, mortality rates have remained largely unchanged. This article conducts an in-depth review of the literature surrounding IVC injuries and a detailed discussion of operative strategies and management as survivability is ultimately dependent on the grade of injury, location, and the presence of hemorrhagic shock.

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