gms | German Medical Science

128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

Laparoscopic management of celiac artery compression syndrome

Meeting Abstract

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  • Katharina Rubach - DRK Klinikum Köpenick, Allgemein- und Visceralchirurgie, Berlin
  • Jana Lessel - DRK Klinikum Köpenick, Allgemein- und Visceralchirurgie, Berlin
  • Matthias Pross - DRK Klinikum Köpenick, Allgemein- und Visceralchirurgie, Berlin
  • Michael Naundorf - DRK Klinikum Köpenick, Berlin

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch793

DOI: 10.3205/11dgch793, URN: urn:nbn:de:0183-11dgch7931

Veröffentlicht: 20. Mai 2011

© 2011 Rubach et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Celiac artery compression syndrome is a rare disease, which leads to constriction of the celiac artery through the deep-seated approach of the median arcuate ligament on the spinal column on the one hand and causes an irritation of the celiac plexus on the other hand. Affected are mostly young- and middle-aged adults.

Materials and methods: The variability of the symptomatic induces the elimination of other diseases. For clinical diagnosis the lateral aortography is international gold standard, but also the colour-coded duplex sonography grows in popularity. In this demonstrated case the symptoms of the 25-years old patient completely disappeared after laparoscopic division of the median arcuate ligament with resection of the vegetative fibres of the celiac plexus.

Results: The patient is a 25-year-old male with a 2-year history of epigastric abdominal pain and nausea. Aortography demonstrated an extrinsic compression of the celiac artery. A full laparoscopic skeletonization of the celiac artery and branch vessels was performed.

Postoperative duplex U/S demonstrated flow rate reduction after the median arcuate ligament release and no residual stenosis. The patient was discharged on postoperative day 5 and remained asymptomatic after 3 months of follow-up.

Conclusion: The therapeutic options, especially concerning the indication for surgery, are discussed controversial, because in long-term view not in all cases the patients benefit from the surgery. Laparoscopic release of the median arcuate ligament is a novel approach to the management of celiac artery compression syndrome. The role of minimally invasive techniques to manage Dunbar-Syndrome is evolving but they appear to be a safe alternative to open surgery.

-Authors Rubach, Katharina and Lessel, Jana contributed equally to this work