Exertional Abdominal Pain In A Crew Athlete - Page #4
 

Working Diagnosis:
Celiac Artery Compression Syndrome

Treatment:
Laproscopic release of the median arcuate ligament

Outcome:
Her abdominal pain resolved.

Author's Comments:
Rare diagnosis with uncertain pathology. Theories behind pathology include: congenital anatomic variation and celiac nerve plexus compression rather than celiac artery compression. Results of surgical release of the median arcuate ligament have mixed outcomes.

Editor's Comments:
-Vascular etiologies should be considered in athletes with unexplained abdominal pain.
-Multiple imaging modalities may be needed to arrive at the correct diagnosis in unexplained abdominal pain.

References:
Bech F MD, Loesberg A MD, Rosenblum J MD, Glagov S MD, Gewertz B MD. Median arcuate ligament compression syndrome in monozygotic twins. Journal of Vascular Surgery. May 1994; 19: 934-938.
Delis K, Gloviczki P, Altuwaijri M, McKusick MC. Median arcuate ligament syndrome: open celiac artery reconstructio and ligament division after endovascular failure. Journal Vascular Surgery. 2007 Oct; 46: 799-802.
Gloviczki P, Duncan A. Treatment of Celiac Artery Compression Syndrome: Does it Really Exist? Perspectives in Vascular Surgery and Endovascular Therapy. 2007; 19: 259-263.
Jimenez JC, Harlander-Locke M, Dutson EP. Open and laproscopic treatment of median arcuate ligament syndrome. Journal of Vascular Surgery. Sep 2012; 56: 869-873.
Okten R, Kucukay F, Tola M, Bostanci B, Cumhur T. Is celiac artery compression syndrome genetically inherited?: A case series from a family and review of the literature. European Journal of Radiology. 2012; 81: 1089-1093.
Scovell S MD, Hamdan A MD. Celiac artery compression syndrome. Up-to-Date. January 2014.

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