RESUMO
The article presents results of examinations and surgical treatment of 300 patients aged from 19 through 72 years with the syndrome of compression of the celiac trunk of the abdominal aorta. Under study were the symptoms and features of the clinical course as well as the possibilities of diagnosis with the help of ultrasonic duplex scanning and aortography. The principal method of treatment of this syndrome is thought to be operative decompression of the celiac trunk resulting in the reestablished hemodynamics in this vessel and in recovery of the greatest part of the patients.
Assuntos
Aorta Abdominal/fisiopatologia , Aorta Abdominal/cirurgia , Estenose da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/cirurgia , Artéria Celíaca/fisiopatologia , Artéria Celíaca/cirurgia , Adulto , Idoso , Aorta Abdominal/diagnóstico por imagem , Estenose da Valva Aórtica/diagnóstico , Velocidade do Fluxo Sanguíneo , Artéria Celíaca/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ultrassonografia , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
On the basis of an analysis of 69 patients including 2 personal observations the authors discuss the questions of pathogenesis, clinical picture, diagnosis and treatment of aneurysms of the pancreaticoduodenal artery in association with stenosis or occlusion of the celiac trunk (CT). A description of 2 cases with a true not broken aneurysms of the inferior pancreaticoduodenal artery and subocclusion of the celiac trunk is given which was caused by compression of the latter by the median arcuate ligament of the diaphragm and neurofibrous tissue of the celiac plexus. These patients were detected as a result of examinations and operative treatment of 556 patients with compressive stenosis of the celiac trunk for the period from 1982 through 2002. In one case a transcatheter embolization of the aneurysm was fulfilled followed in 3 months by a compression of the celiac trunk, in the other case a compression of the celiac trunk was made first and then in 5 months it was followed by resection of the aneurysm with a favorable outcome.
Assuntos
Aneurisma/complicações , Aneurisma/cirurgia , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/cirurgia , Artéria Celíaca , Duodeno/irrigação sanguínea , Pâncreas/irrigação sanguínea , Adulto , Idoso , Aneurisma/diagnóstico por imagem , Aneurisma/terapia , Angiografia , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/etiologia , Artérias , Artéria Celíaca/diagnóstico por imagem , Plexo Celíaco , Descompressão Cirúrgica , Embolização Terapêutica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , UltrassonografiaRESUMO
Operations for compression stenosis of the celiac trunk (CSCT) were made on 97 patients aged 5.5-18 years (56 women and 41 men). Three basic clinical syndromes were observed: pain abdominal, dyspeptic and neurovegetative. The appearance or intensification of abdominal pains observed in 71.3% of the patients were connected with meal, in 59.69% of them it was simultaneous with physical exercise. The diagnosis of OSCT was based mainly on findings of ultrasonic duplex scanning. The indications to decompression of the celiac trunk were: clinical manifestations of CSCT, the stenosis degree at the maximal expiration more than 50%, peak systolic velocity of the blood flow more than 2 m/s and a gradient of arterial pressure more than 15 mm Hg. The decompression of the celiac trunk consisted in the dissection of a median arcuate ligament of the diaphragm, its interior crura and celiac ganglion fibers. Convalescence and recovery was stated in 87 of 97 patients in the nearest and long-term follow-up.
