scholarly journals Celiac artery compression: Dunbar syndrome

2019 ◽  
Vol 18 ◽  
Author(s):  
Giovanna Mezzalira Santos ◽  
Luiz Marcelo Aiello Viarengo ◽  
Marcos Danillo Peixoto Oliveira
Keyword(s):  
Treatment Options ◽  
Rare Condition ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Interesting Case ◽  
Median Arcuate Ligament ◽  
Extrinsic Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Celiac Artery Compression

Abstract Celiac artery compression syndrome, also referred to as median arcuate ligament syndrome, celiac axis syndrome or Dunbar syndrome is a rare disorder consequent to extrinsic compression of the celiac trunk by the median arcuate ligament. Doppler ultrasound, multi-slice computed tomography angiography, magnetic resonance angiography, or invasive selective angiography can identify stenosis of the initial segment of the celiac artery and confirm diagnosis. Treatment options include open surgical or videolaparoscopic section of the median arcuate ligament and the fibers of the celiac plexus, or percutaneous transluminal angioplasty via an endovascular approach. We report herein an interesting case of a 38-year-old woman diagnosed with this rare condition and successfully treated with the surgical strategy.

scholarly journals Dunbar syndrome: a rare presentation of abdominal angina treated by revascularization of the celiac artery by endovascular stenting

2018 ◽  
Vol 6 (6) ◽  
pp. 2169 ◽  
Author(s):  
Rakshith Shetty ◽  
K. Subramanyam ◽  
Chinthu Sara Jacob
Keyword(s):  
Epigastric Pain ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Rare Presentation ◽  
Extrinsic Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome

Median arcuate ligament syndrome (MALS) is a rare entity characterized by extrinsic compression of the celiac artery and symptoms of postprandial epigastric pain, nausea, vomiting, and weight loss mimicking mesenteric ischemia. The following case illustrates a rare cause of abdominal pain, where this young woman was found to have celiac trunk stenosis , secondary to compression of the trunk by the median arcuate ligament. She underwent a successful stenting to the ostial celiac trunk, thus reliving her symptomatically. Decompression of the celiac artery is the general approach. Usually post PTA, once revascularisation is achieved, 75% of the patients remain asymptomatic at follow up.

scholarly journals Surgical treatment of Dunbar syndrome

2013 ◽  
Vol 12 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Luís Henrique Gil França ◽  
Carla Mottin
Keyword(s):  
Clinical Condition ◽  
Epigastric Pain ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Transluminal Angioplasty ◽  
Celiac Artery Compression Syndrome ◽  
Extrinsic Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Angioplasty And Stenting

Dunbar syndrome or celiac artery compression syndrome is an infrequently described clinical condition with poorly defined diagnostic criteria and an obscure pathophysiology. It is usually associated with an extrinsic compression upon the celiac axis near its takeoff from the aorta by fibrous diaphragmatic bands or sympathetic neural fibers. The authors report the case of a 70-year-old male patient presenting with nausea, epigastric pain, and weight loss. An aortography showed a compression of the celiac trunk. A preliminary attempt at percutaneous transluminal angioplasty and stenting proved unsuccessful. The patient became asymptomatic and his clinical condition improved after surgical release of the celiac trunk by partial section of the arcuate ligament of the diaphragm and with resection of the neural, fibrotic, and lymphatic tissues surrounding the aortic and visceral vessels. The purpose of this report is to discuss the indications and the therapeutic options of this syndrome.

scholarly journals Dunbar syndrome as a cause of chronic abdominal pain in a 24-year-old female

2020 ◽  
Vol 7 (1) ◽  
pp. 15
Author(s):  
Zachary A Koenig ◽  
Joel Yednock
Keyword(s):  
Abdominal Pain ◽  
Duplex Ultrasound ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
External Compression ◽  
Cross Sectional ◽  
Downward Displacement ◽  
Arcuate Ligament ◽  
Dunbar Syndrome

External compression of the celiac artery by the median arcuate ligament is referred to as Dunbar syndrome, which is an eponym for celiac axis syndrome or median arcuate ligament syndrome. It is correlated with the archetypal triad of postprandial abdominal pain, weight loss of greater than 20 pounds, and an abdominal bruit on auscultation. This is often accompanied by epigastric tenderness, vomiting, and nausea. Given its lack of symptomatic specificity, Dunbar syndrome is a diagnosis of exclusion for unexplained episodic abdominal discomfort. Here, we present a unique case of a 24-year-old woman who experienced several months of chronic abdominal distress and an extensive workup prior to being diagnosed with Dunbar syndrome. The diagnosis was made via cross-sectional abdominal imaging and duplex ultrasound with respiratory maneuvers, which showed downward displacement of the celiac trunk, post-stenotic dilatation, and increased flow velocity on expiration. She underwent successful laparoscopic division of the median arcuate ligament which greatly alleviated her pain.

scholarly journals Intraoperative trans-esophageal echographic evaluation of the celiac artery flow after arcuate ligament resection in a case of Dunbar Syndrome. A case report

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Giacomo Coppalini ◽  
◽  
Enrico Giustiniano ◽  
Fulvio Nisi ◽  
Carlo Castoro ◽  
...  
Keyword(s):  
Weight Loss ◽  
Case Report ◽  
Rare Disease ◽  
Epigastric Pain ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Artery Flow

Dunbar Syndrome (DS), also known as Median Arcuate Ligament (MAL) syndrome, is a rare disease in which the celiac trunk is compressed by a fibrous attachment at the diaphragmatic crura causing abdominal angina with a large spectrum of symptoms including nausea, vomiting, weight loss, and postprandial epigastric pain.

scholarly journals Median arcuate ligament syndrome presenting with unintentional weight loss and epigastric pain

2019 ◽  
Vol 6 (10) ◽  
pp. 3839
Author(s):  
Mohammed Taher Mujahid ◽  
Virendra Kumar Soni ◽  
Rahul Saini
Keyword(s):  
Weight Loss ◽  
Rare Case ◽  
Surgical Intervention ◽  
Epigastric Pain ◽  
Rare Condition ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Extrinsic Compression ◽  
Arcuate Ligament

Median arcuate ligament syndrome is a rare condition characterized by extrinsic compression of celiac artery and celiac plexus by the median arcuate ligament. Patients typically present with chronic postprandial pain, nausea and occasionally, vomiting and weight loss. Treatment of this syndrome is laparoscopic or open surgical release of median arcuate ligament and gangliectomy. We report a rare case of median arcuate ligament syndrome in a patient who presented with abdominal pain and nausea. The patient was evaluated, investigated and planned for surgical intervention but the patient refused for treatment.

scholarly journals Atypical Presentation of Median Arcuate Ligament Syndrome in the Emergency Department

2019 ◽  
Vol 3 (4) ◽  
pp. 413-416 ◽  
Author(s):  
Abby Sapadin ◽  
Ryan Misek
Keyword(s):  
Emergency Department ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Rare Condition ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Celiac Artery Compression Syndrome ◽  
Gi Symptoms ◽  
Arcuate Ligament

Celiac artery compression syndrome, also called median arcuate ligament syndrome (MALS), is a rare condition in which the diaphragmatic crura compresses the celiac axis. This results in a constellation of primarily gastrointestinal (GI) symptoms including nausea, vomiting, postprandial abdominal pain, and weight loss. It is typically a diagnosis of exclusion and may be detected via several imaging techniques including ultrasound and computed tomography angiography. We present an atypical case of MALS detected in the emergency department (ED). We review the symptomatology, diagnostic workup, and treatment options here, as well as discuss implications concerning revisits to the ED for recurrent GI symptoms.

Assessment of celiac artery compression using color-coded duplex sonography

2020 ◽  
Vol 76 (3) ◽  
pp. 413-423 ◽  
Author(s):  
Claudia Römer ◽  
Thomas Fischer ◽  
Oliver Haase ◽  
Martin Möckel ◽  
Bernd Hamm ◽  
...  
Keyword(s):  
Diagnostic Performance ◽  
Peak Systolic Velocity ◽  
Rare Condition ◽  
Diagnostic Value ◽  
Celiac Artery ◽  
Breath Hold ◽  
Median Arcuate Ligament ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Arcuate Ligament

BACKGROUND: Median arcuate ligament syndrome (MALS) is a rare condition due to compression of the celiac artery (CA) by an anatomically abnormal median arcuate ligament. With ultrasonography (US) as first-line diagnostic modality in patients with unclear abdominal pain, there is limited data on its diagnostic performance in MALS. OBJECTIVE: To investigate the value of CA peak systolic velocity (PSV) in the workup of patients with suspected MALS. METHODS: Patients with diagnosis of MALS between 2009 and 2019 were referred by Department of Visceral Surgery after clinical and gastroenterological workup. Diagnosis was confirmed by surgery or further cross-sectional imaging. B-mode US findings and PSV in the CA during various respiratory states were compared between patients with a final MALS diagnosis and patients not meeting the diagnostic criteria. RESULTS: Patients with proven MALS (n = 10) had higher median CA PSV during normal inspiratory breath-hold (239 [IQR, 159–327] vs. 138 [IQR, 116–152] cm/s; p < #x003C;< #x200A;0.001), and expiratory breath-hold (287 [IQR, 191–412] vs. 133 [IQR, 115–194] cm/s; p < #x003C;< #x200A;0.001) compared to patients without MALS (n = 26). CA PSV in both inspiratory breath-hold (AUC 0.88, 95% CI 0.77–1.00) and expiratory breath-hold (AUC 0.89, 95% CI 0.78–1.00) was of diagnostic value for confirming MALS. The best diagnostic performance (100% sensitivity, 80% specificity) was found for the combination of CA PSVexpiration + 2.4 · PSVinspiration > 550 cm/s . CONCLUSIONS: Since results on optimal cutoff values are inconsistent, a combination of CA PSVs during breathing maneuvers may help to diagnose or rule out MALS.

Chronic abdominal pain as a manifestation of congenital compressional stenosis of the celiac trunk in children: world and own experience

2020 ◽  
Vol 15 (4) ◽  
pp. 62-68
Author(s):  
R.A. Zainulabidov ◽  
◽  
A.Yu. Razumovsky ◽  
A.I. Khavkin ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lymph Nodes ◽  
Congenital Abnormality ◽  
Celiac Trunk ◽  
Chronic Abdominal Pain ◽  
Median Arcuate Ligament ◽  
Modern Methods ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Methods Of Treatment

Celiac trunk compression stenosis or Dunbar's syndrome, characterized by chronic abdominal pain, is a congenital abnormality based on compression of the celiac trunk by the inner legs of the median arcuate ligament of the diaphragm and neurofibrous tissue of the celiac plexus. In the overwhelming majority of cases, Dunbar's syndrome is a congenital malformation, but variants of compression of the celiac trunk by enlarged lymph nodes are also possible and is considered an acquired disease. The review considers modern methods of treatment of Dunbar syndrome in children and the supervision of this group of patients. Key words: Compression celiac trunk stenosis in children, Dunbar syndrome, median arcuate ligament tsyndrome

scholarly journals Technique and outcomes of robot-assisted median arcuate ligament release for celiac artery compression syndrome

2015 ◽  
Vol 61 (5) ◽  
pp. 1278-1284 ◽  
Author(s):  
Stijn J.J. Thoolen ◽  
Walderik J. van der Vliet ◽  
Tara S. Kent ◽  
Mark P. Callery ◽  
Martin J. Dib ◽  
...  
Keyword(s):  
Celiac Artery ◽  
Robot Assisted ◽  
Median Arcuate Ligament ◽  
Celiac Artery Compression Syndrome ◽  
Compression Syndrome ◽  
Arcuate Ligament ◽  
Celiac Artery Compression

scholarly journals Multiple Aneurysms of the Inferior Pancreaticoduodenal Artery: A Rare Complication of Acute Pancreatitis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Chris Klonaris ◽  
Emmanouil Psathas ◽  
Athanasios Katsargyris ◽  
Stella Lioudaki ◽  
Achilleas Chatziioannou ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Rare Complication ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Median Arcuate Ligament ◽  
Pancreaticoduodenal Artery ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
History Of ◽  
Technical Considerations

Inferior pancreaticoduodenal artery (IPDA) aneurysms are uncommon, representing nearly 2% of all visceral aneurysms, and sporadically associated with celiac artery stenosis. Multiple IPDA aneurysms have been rarely reported. We report a case of a 53-year-old female patient with a history of prior pancreatitis, who presented with two IPDA aneurysms combined with median arcuate ligament-syndrome-like stenosis of the celiac trunk. The patient was treated successfully with coil embolization under local anesthesia. The procedure is described and illustrated in detail and the advantages and technical considerations of such an approach are also being discussed.

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