Síndromes compresivos de las arterias viscerales. Síndrome del ligamento arcuato. Síndrome de Wilkie / Compressive syndromes of the visceral arteries. Arcuate ligament syndrome. Wilkie syndrome

Los síndromes compresivos de los vasos sanguíneos a nivel abdominal son entidades nosológicas que se pueden considerar poco frecuentes. La sintomatología clínica en la mayoría de los casos y generalmente se suele llegar al diagnostico descartando otras patologías y utilizando las modernas tecnologías que permiten en la mayoría de los casos llegar a un diagnostico evidenciando el problema compresivo. Su tratamiento, desde el punto de vista conceptual es la descompresión pudiéndose aplicar diferentes alternativas que deben de ser aplicadas, en especial las mas agresivas con una adecuada ponderación de riesgo beneficio, teniendo en consideración los diferentes condicionantes que suelen acompañar a este tipo de problemas. (AU)

Compressive syndromes of the blood vessels at the abdominal level are nosological entities that can be considered infrequent. The clinical symptoms in most cases and generally the diagnosis is usually reached by ruling out other pathologies and using modern technologies that allow in most cases to reach a diagnosis showing the compression problem. Its treatment, from the conceptual point of view, is decompression, and different alternatives can be applied that must be applied, especially the most aggressive oneswith an adequate risk-benefit weighting, taking into account the different conditioning factors that usually accompany this type ofproblems. (AU)

Median Arcuate Ligament Syndrome With Celiac Artery Aneurysm and Dissection.

Median arcuate ligament syndrome (MALS) is the chronic symptomatic compression of the celiac artery by the median arcuate ligament. A known potential sequela of MALS is celiac artery aneurysm, which could predispose the diseased artery to dissection. However, the presence of celiac artery dissection and MALS is yet to be reported. Here, we present a case of MALS with a coincident celiac artery aneurysm and dissection.

Hybrid Laparoscopic and Endovascular Treatment for Median Arcuate Ligament Syndrome: Case Report and Review of Literature.

Median arcuate ligament syndrome is a rare cause of chronic gastrointestinal ischemia caused by compression of median arcuate ligament on the celiac trunk. A 38-year-old male presented at our institution with unspecific crampy abdominal pain. After several diagnostic examinations, he firstly underwent arcuate ligament resection by laparoscopic approach and 2 months later, he underwent percutaneous transluminal angioplasty with stenting of the stenotic vessel. Postoperatory and follow-up controls showed regular patency of the artery with complete relief of abdominal symptoms. We propose a review of the literature on this uncommon condition, describing different surgical approaches.

Symptomatic Pancreaticoduodenal Artery Aneurysm in a Patient with Prior Aortic Surgery and Celiac Trunk Obstruction: Case Report.

Pancreaticoduodenal artery aneurysm (PDA) is a rare visceral aneurysm and represents 1.5% of all the visceral arterial aneurysms. An 81-year-old man was admitted with acute abdominal pain. He suffered 2 previous episodes of pancreatitis and underwent abdominal aortic aneurysm repair 11 years before. The computed tomography scan revealed a 92-mm aneurysm of inferior PDA artery with prerupture signs associated with the celiac trunk obstruction. The patient underwent a selective catheterization and embolization of superior PDA artery with coils, inferior PDA artery with 12-mm Amplatzer, and aneurysm sac embolization by Onyx and coils. The postoperative course was uneventful and the patient was discharged on the fourth postoperative day. Celiac trunk stenosis could be one of the possible etiology but atherosclerosis and pancreatitis are the 2 most common risk factors. Treatment of choice is yet to be established and it has to be properly defined "case by case"; surgery, endovascular embolization, or percutaneous thrombin injection are valuable approaches.

Tratamento laparoscópico da compressão do tronco celíaco pelo ligamento arqueado do diafragma associado a correção endovascular do aneurisma de artéria pancreatoduodenal: relato de caso / Laparoscopic treatment of celiac axis compression by the median arcuate ligament and endovascular repair of a pancreaticoduodenal artery aneurysm: case report

A compressão do tronco celíaco pelo ligamento arqueado mediano do diafragma pode causar sintomas inespecíficos como dor abdominal, vômitos e emagrecimento. Existe uma associação comprovada entre estenoses ou oclusões do tronco celíaco e aneurismas da artéria pancreatoduodenal. Nas situações em que essa associação ocorre, a estratégia de tratamento deve ser individualizada. Relatamos o caso de uma paciente com aneurisma de artéria pancreatoduodenal associado à compressão do tronco celíaco pelo ligamento arqueado, manejados, respectivamente, por técnicas endovasculares e laparoscópicas

Compression of the celiac axis by the median arcuate ligament of the diaphragm can cause nonspecific symptoms such as abdominal pain, vomiting, and weight loss. There is a known association between stenosis or occlusion of the celiac trunk and aneurysms of the pancreaticoduodenal artery. Treatment strategies for patients who have this association should be selected on a case-by-case basis. We describe the case of a patient with pancreaticoduodenal artery aneurysm associated with compression of the celiac trunk by the arcuate ligament, which were managed with endovascular and laparoscopic techniques, respectively