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1.
Medicina (B.Aires) ; 79(5): 424-427, oct. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1056745

ABSTRACT

La arteritis de Takayasu es una vasculitis idiopática y granulomatosa crónica que se manifiesta en forma de panaortitis, de etiología desconocida, aunque se postula un origen autoinmune. Es progresiva y genera, tanto en adultos como en niños, estenosis segmentaria, oclusión, dilatación y/o aneurismas. La vasculitis aislada gastrointestinal sin afectación sistémica es rara. Este caso lleva a tener en cuenta la manifestación abdominal atípica de la arteritis de Takayasu en el diagnóstico diferencial de un síntoma frecuente, como la epigastralgia, y a destacar el rol que ocupan en la actualidad los métodos de imágenes no invasivos para su diagnóstico.


Takayasu arteritis is an idiopathic and chronic granulomatous vasculitis manifested in the form of panaortitis, of unknown etiology, even though an autoimmune origin is postulated. It is progressive and generates, in adults and children, segmental stenosis, occlusion, dilation and / or aneurysms. Isolated gastrointestinal vasculitis without systemic involvement is rare. This case leads us to take into account the atypical abdominal manifestation of Takayasu arteritis in the differential diagnosis of a frequent symptom, such as epigastralgia, and to highlight the role currently played by non-invasive imaging methods for its diagnosis.


Subject(s)
Humans , Male , Middle Aged , Celiac Artery/pathology , Takayasu Arteritis/pathology , Celiac Artery/diagnostic imaging , Angioplasty/methods , Takayasu Arteritis/therapy , Takayasu Arteritis/diagnostic imaging , Diagnosis, Differential , Positron Emission Tomography Computed Tomography , Computed Tomography Angiography
2.
Rev. chil. cir ; 67(3): 306-308, jun. 2015. ilus
Article in Spanish | LILACS | ID: lil-747506

ABSTRACT

Background: Median arcuate ligament syndrome (SLAM) is caused by extrinsic compression of the celiac artery by fibrous bands of this ligament and periaortic lymph node tissue. Case report: We report a 59 years old man with a history of weight loss, epigastric pain and a postprandial murmur. The syndrome was diagnosed by CT angiography. The patient was operated, performing a midline laparotomy and releasing the extrinsic compression. An early and sustained remission of symptoms was achieved.


Introducción: El síndrome del ligamento arcuato medio (SLAM), es causado por la compresión extrínseca del tronco celíaco por bandas fibrosas de este ligamento y tejido ganglionar periaórtico. Caso clínico: Reportamos el caso de un hombre de 59 años con historia de baja de peso, dolor postprandial y soplo epigástrico, al cual se le diagnostica SLAM por medio de angioTC. Se realiza abordaje quirúrgico, con laparotomía media y liberación de la compresión extrínseca, logrando remisión de los síntomas de forma inmediata y sostenida. El SLAM es una causa infrecuente de dolor abdominal, requiere estudio por imágenes para su diagnóstico, la resolución quirúrgica constituye su tratamiento.


Subject(s)
Humans , Male , Middle Aged , Celiac Artery/surgery , Celiac Artery/pathology , Constriction, Pathologic/surgery , Constriction, Pathologic/etiology , Ligaments/surgery , Ligaments/pathology , Angiography , Tomography, X-Ray Computed
3.
J. vasc. bras ; 13(2): 150-154, Apr-Jun/2014. graf
Article in English | LILACS | ID: lil-720873

ABSTRACT

Spontaneous dissection of the celiac trunk is quite an uncommon medical condition, with few case reports in the medical literature. Sudden epigastric abdominal pain is the most common complaint reported by patients, but due to the rarity of this disease in clinical practice and the nonspecific nature of its symptoms, a high degree of clinical suspicion is needed to establish diagnosis. However, improvements in imaging techniques are facilitating diagnosis of this clinical entity, increasing its detection rate. The ideal treatment has not yet been fully established in the literature and the available therapeutic strategies are conservative medical treatment, surgical revascularization or endovascular intervention. In this article we report on three cases of spontaneous dissection of the celiac trunk and conduct a review of the literature on this disease...


A dissecção espontânea do tronco celíaco é uma condição médica incomum, com poucos relatos de casos publicados na literatura médica. A dor abdominal súbita no epigástrio é o sintoma mais frequentemente manifestado pelos pacientes; porém, devido à raridade dessa doença na prática clínica e à inespecificidade de seus sintomas, é necessário um alto grau de suspeição para o estabelecimento do seu diagnóstico. Nesse contexto, o aperfeiçoamento das técnicas de exames de imagem vem possibilitando o diagnóstico desta entidade clínica com maior facilidade, aumentando a sua taxa de detecção. O tratamento ideal ainda não está completamente bem estabelecido na literatura, sendo que as estratégias terapêuticas disponíveis são o tratamento médico conservador, a revascularização cirúrgica e a intervenção endovascular. Neste artigo, nós relatamos três casos de dissecção espontânea do tronco celíaco e realizamos uma revisão de literatura sobre esta doença...


Subject(s)
Humans , Male , Female , Middle Aged , Celiac Artery/pathology , Celiac Artery , Angiocardiography , Dissection , Abdominal Pain/complications
4.
Rev. chil. radiol ; 20(4): 149-155, 2014. ilus
Article in Spanish | LILACS | ID: lil-734822

ABSTRACT

The aim of this article is to describe the clinical, pathophysiology and diagnostic imaging aspects of median arcuate ligament syndrome (MALS) by presenting clinical cases and literature review. Development: The median arcuate ligament syndrome corresponds to a clinical syndrome secondary to the extrinsic compression of the celiac trunk by fibrous bands of the median arcuate ligament. In recent decades, some authors have questioned its true meaning and existence given the reported cases of asymptomatic patients who presented extrinsic compression of the celiac trunk by MAL. However, the presence of intestinal angina symptoms and certain specific imaging findings leads to consider its differential diagnosis and directs toward the corresponding study. The diagnosis is made by using Doppler ultrasound, Multislice Computed Tomography (CT) Angiography and Magnetic Resonance Angiography (MRA), the Angiography-fluoroscopy being left out of the first-line study. In recent years use of MRA has increased due to the absence of ionizing radiation and the high efficiency in the diagnosis. Within its complications include acute mesenteric angina and pancreaticoduodenal artery aneurysms secondary to the extensive formation of adjacent collateral circulation. Surgical treatment has been the most effective, having a very low recurrence.


El objetivo de este artículo es describir la presentación clínica, fisiopatología y diagnóstico imagenológico del síndrome del ligamento arcuato medio (LAM), mediante la presentación de casos clínicos y revisión de la literatura. Desarrollo: El síndrome del ligamento arcuato medio corresponde a un síndrome clínico secundario a compresión extrínseca del tronco celíaco determinado por bandas fibróticas del ligamento arcuato medio. En las últimas décadas, algunos autores han puesto en tela de juicio su verdadero significado y existencia dado los casos reportados de pacientes asintomáticos que presentan compresión extrínseca del tronco celíaco por LAM. Sin embargo, la presencia de un cuadro de angina intestinal y ciertos hallazgos imagenológicos específicos, hacen considerar su diagnóstico diferencial y orientar el estudio correspondiente. El diagnóstico se realiza mediante el uso de Ecografía Doppler, Angiografía por Tomografía Computada Multicorte y Angioresonancia Magnética, quedando la Angiografía Fluoroscópica fuera del estudio de primera línea. En los últimos años se ha potenciado el uso de la Angioresonancia por la ausencia de radiación ionizante y la gran eficacia en el diagnóstico. Dentro de sus complicaciones se encuentran la angina mesentérica aguda y aneurismas de la arteria pancreático-duodenal secundarios a la extensa formación de circulación colateral adyacente. El tratamiento más efectivo ha sido el quirúrgico, existiendo una muy baja recidiva.


Subject(s)
Humans , Male , Adult , Female , Aged , Angiography , Celiac Artery , Arterial Occlusive Diseases , Tomography, X-Ray Computed , Celiac Artery/pathology , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/physiopathology , Constriction, Pathologic , Diaphragm , Magnetic Resonance Imaging , Ligaments , Ultrasonography, Doppler
5.
J. vasc. bras ; 12(1): 57-61, jan.-mar. 2013. ilus
Article in English | LILACS | ID: lil-670390

ABSTRACT

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.


A síndrome de Dunbar ou compressão do tronco celíaco é uma condição clínica infrequente, com poucos critérios para diagnóstico e com patofisiologia obscura. Está usualmente associada à compressão extrínseca do tronco celíaco por banda fibrosas do diafragma e fibras neurais simpáticas, próximo a sua emergência da aorta. Os autores relatam um caso de um paciente de 70 anos de idade com quadro de náuseas, dor epigástrica e perda de peso. Uma arteriografia mostrou compressão do tronco celíaco. Uma primeira tentativa de angioplastia com stent foi realizada em outro serviço, mas sem sucesso. Após o tratamento cirúrgico que consistiu de secção parcial do ligamento arqueado do diafragma com ressecção dos tecidos fibróticos, neurais e linfáticos que circundavam a aorta e as artérias viscerais, o paciente obteve melhora clínica e tornou-se assintomático. O objetivo deste estudo é discutir as indicações e opções terapêuticas desta síndrome.


Subject(s)
Humans , Aged , Celiac Artery/surgery , Celiac Artery/pathology , Celiac Artery , Cardiovascular Surgical Procedures/rehabilitation , Angiography/methods , Angioplasty/methods
6.
J. vasc. bras ; 12(1): 68-74, jan.-mar. 2013. ilus
Article in Portuguese | LILACS | ID: lil-670392

ABSTRACT

A dissecção espontânea das artérias viscerais é um evento relativamente raro. Dor abdominal súbita no epigástrio é o sintoma mais frequentemente manifestado pelos pacientes. O avanço das técnicas de exames de imagem possibilitou o diagnóstico deste evento com maior facilidade, aumentando a incidência das dissecções das artérias viscerais. O tratamento clínico conservador, a revascularização cirúrgica, e a terapia endovascular são as três possíveis opções terapêuticas. Neste artigo, relatamos os casos de dois pacientes com dissecção espontânea do tronco celíaco conduzidos de formas diversas, de acordo com a apresentação clínica e exames de imagem, além de realizar uma revisão bibliográfica sobre esta doença.


Spontaneous dissection of visceral arteries is a quite rare event. Sudden abdominal pain in the epigastrium is the most frequent symptom. Advances in imaging techniques have made it easier to establish the diagnosis of this event, increasing the incidence of dissections of visceral arteries. Conservative medical treatment, surgical revascularization, and endovascular therapy are the three treatment options available. We report two cases of patients with spontaneous dissection of the celiac trunk that received different treatments based on clinical presentation and imaging studies. We also conducted a literature review on this disease.


Subject(s)
Humans , Male , Adult , Aortic Aneurysm, Abdominal/therapy , Celiac Artery/pathology , Catheterization/methods , Embolization, Therapeutic/methods , Angiography/methods , Dissection/methods , Magnetic Resonance Spectroscopy/methods , Endovascular Procedures/rehabilitation
7.
Rev. arg. morfol ; 1(4): 40-43, 2012. ilus
Article in Spanish | LILACS | ID: lil-733603

ABSTRACT

El tronco celíaco es la primera rama visceral de la aorta abdominal, tiene la función de irrigar al hígado, bazo y estómago, además accesoriamente duodeno y páncreas. Nuestra intención fue describir experiencia en la disección de este ramo arterial, siendo ésta punta pié inicial para la elaboración de una propia casuística. Utilizamos para esta disección un cadáver adulto de sexo femenino conservado en formol al 10 % sin previa selección. El tronco celíaco (TC) fue abordado vía abdomnal, previa incisión medial del abdomen, al igual que sus ramos terminales y respectivos órganos que irriga. Se diseco en conjunto la pieza anatómica formada por el TC, arteria hepática, esplénica y coronaria estomáquica; hígado, estomago, bazo, páncreas y duodeno, con sus respectivas irrigaciones. Esta actividad fue realizad en el año lectivo 2011 por alumnos de primer año en en coordinación y dirección de un superior a cargo.


The celiac trunk is the first brnch of the abdominal nal aorta visceral, has the function of irrigating the liver, spleen and stomach, duodenum and páncreas alsoincidentally. Our intention was to describe the experiencia in the dissection of the arterial branch, this beingstarting point to the preparation of a casuistry own. Usedfor this dissection a female adult cadáver preserved in10% formalin without prior seletion. The celiac artery was approached route abdominal previous incisión medial abdomen, as well as their respective termial branches and organs that irrigates. Was dissected in anatomical piece set consistig of the celiac trunk, hepatic artery, splenic artery and stomachic coronary artery; liver, stomach, spleen pancreas and duodenum, with their irrigation. This activity was conducted in the academicyear 2011 for first years students in coordination and direction of a superior charge.


Subject(s)
Aorta, Abdominal , Celiac Artery/anatomy & histology , Celiac Artery/pathology , Celiac Artery
8.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2011; 21 (5): 301-303
in English | IMEMR | ID: emr-131106

ABSTRACT

Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis and intervention to adequately restore mesenteric blood flow and to prevent bowel necrosis and patient death. While, almost always superior and inferior mesenteric arteries are involved, we report a 57-year-old male with an unusual celiac artery trunk thrombosis leading to gastero-duodenal and hepato-splenic infarction, and presenting an acute liver failure


Subject(s)
Humans , Male , Thrombosis/complications , Celiac Artery/diagnostic imaging , Ischemia , Celiac Artery/pathology , Vascular Diseases , Liver Failure, Acute/etiology , Splenic Infarction/diagnostic imaging
9.
J. vasc. bras ; 9(1): 4-13, 2010. tab
Article in Portuguese | LILACS | ID: lil-557195

ABSTRACT

A eventual relação entre a aterosclerose das artérias dos membros inferiores com a aterosclerose das artérias intestinais foi pouco estudada. Objetivo: Avaliar pela ecografia vascular (Doppler) presença de lesões com estenose 70 por cento na artéria mesentérica superior e/ou tronco celíaco em doentes com arteriopatia obstrutiva crônica dos membros inferiores. Método: Foram estudados dois grupos, cada um com 60 doentes (40 homens e 20 mulheres). O grupo-caso foi composto por doentes com arteriopatia obstrutiva crônica dos membros inferiores, claudicação intermitente limitante ou dor de repouso e/ou lesões tróficas de extremidade, sem queixas gastrintestinais...


Subject(s)
Humans , Male , Female , Celiac Artery/pathology , Mesenteric Artery, Inferior , Arterial Occlusive Diseases/diagnosis , Atherosclerosis/diagnosis , Lower Extremity , Myocardial Ischemia/complications , Echocardiography, Doppler/nursing , Prevalence
10.
Int. j. morphol ; 26(3): 563-566, Sept. 2008. ilus
Article in English | LILACS | ID: lil-556714

ABSTRACT

Knowledge of the branching pattern of the abdominal aorta is clinically important for any abdominal surgeon operating on parts of the gut or neighboring structures like the suprarenals, spleen, pancreas, liver, kidneys and ureter. The presence of abnormal inferior phrenic artery associated with aberrant branch from the celiac trunk supplying the pancreas and duodenum is a rare anomaly. In the present case, we observed four branches of the celiac artery i.e. (a) left gastric artery (b) common hepatic artery (c) splenic artery and (d) an aberrant branch, which took a course inferiorly towards the pancreas. The aberrant artery supplied the body of the pancreas and gave a branch which supplied the horizontal part of the duodenum and then entered the transverse mesocolon to supply the hepatic flexure and some portions of the ascending and the transverse colon. The inferior phrenic artery was absent on the left side. Concomitant anomalies of such type are to be kept in mind by the surgeon, while operating cases of carcinoma head of pancreas and performing kidney transplantations.


El conocimiento del patrón de ramificación de la aorta abdominal es clínicamente importante para cualquier cirujano abdominal que opere en partes del intestino o estructuras vecinas, como glándulas suprarenales, bazo, páncreas, hígado, riñones y uréteres. La presencia anormal de la arteria frénica inferior asociada con una rama aberrante originada del tronco celiaco, supliendo el páncreas y duodeno, es una variación anatómica rara. En el presente caso, se observaron cuatro ramas de la arteria celiaca: (a) arteria gástrica izquierda (b) arteria hepática común (c) arteria esplénica y (d) una rama aberrante, que tuvo un curso inferior hacia el páncreas. La arteria aberrante suministraba irrigación al cuerpo del páncreas y daba una rama para la parte horizontal del duodeno para luego entrar en el mesocolon transverso para irrigar la flexura hepática y algunas partes del colon ascendente y transverso. La arteria frénica inferior estaba ausente en el lado izquierdo. Anomalías concomitantes de este tipo deben ser consideradas por el cirujano, en casos de operación de carcinoma de cabeza de páncreas y la realización de trasplante renal.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Abnormalities, Multiple/surgery , Abnormalities, Multiple/embryology , Aorta, Abdominal/anatomy & histology , Aorta, Abdominal/abnormalities , Aorta, Abdominal/pathology , Vascular Malformations/physiopathology , Abdomen/anatomy & histology , Abdomen/abnormalities , Abdomen/surgery , Celiac Artery/anatomy & histology , Celiac Artery/abnormalities , Celiac Artery/pathology
11.
Int. j. morphol ; 26(2): 293-304, jun. 2008.
Article in English | LILACS | ID: lil-549949

ABSTRACT

The objective of this study was to review some celiac trunk compression syndrome aspects such as: symptom-posture relationship; absence of symptoms; syndrome-age relationship; angiographic study on anatomy of the celiac trunk stenosis; congenital or acquired origin; invasive diagnostic tests; surgical and postoperative results.


El objetivo de este estudio fue hacer una revisión del síndrome de compresión del tronco celíaco, en cuanto a aspectos tales como: relación síntoma-postura; ausencia de síntomas; relación síndrome-edad; estudio angiográfico sobre la anatomía de la estenosis del tronco celíaco; origen congénito o adquirido; tests diagnósticos no invasivos; resultados quirúrgicos y post-quirúrgicos.


Subject(s)
Humans , Male , Female , Celiac Artery/surgery , Celiac Artery/pathology , Arterial Occlusive Diseases/surgery , Arterial Occlusive Diseases/pathology , Angiography , Celiac Artery , Arterial Occlusive Diseases/etiology , Constriction, Pathologic , Diaphragm/surgery , Diaphragm/pathology , Ligaments/surgery , Ligaments/pathology , Posture , Syndrome , Signs and Symptoms
12.
Indian Heart J ; 2006 Mar-Apr; 58(2): 155-7
Article in English | IMSEAR | ID: sea-3468

ABSTRACT

Mesenteric ischemia is a rare but serious cause of abdominal pain.We present the case of a man who had symptomatic mesenteric ischemia, secondary to a superior mesenteric artery stenosis in conjunction with a coeliac artery stenosis. He was treated with balloon angioplasty and stent insertion, and showed good symptomatic improvement.


Subject(s)
Abdominal Pain/etiology , Celiac Artery/pathology , Chronic Disease , Constriction, Pathologic , Humans , Ischemia/etiology , Male , Mesenteric Artery, Superior/pathology , Mesentery/blood supply , Middle Aged , Prosthesis Implantation , Stents
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