Pediatric surgical image. A rare case: celiac artery compression syndrome in an asymptomatic child

Abstract

Celiac artery compression syndrome is a rare disorder and characterized by postprandial intestinal angina caused by insufficient blood supply to the gastrointestinal organs in symptomatic patients. This pathology is also known as median arcuate syndrome. The authors report a case of 12-year-old boy with severe celiac artery compression by the median arcuate ligament that was diagnosed by Magnetic Resonance Angiography (MRA) and color dupplex ultrasonography (US). There was only a bruit in the upper midepigastrium, and there were no gastrointestinal symptoms despite severe compression of celiac trunk. This clinicopathologic entity is very rare but represents severe complaints and clinical results caused by a decreased rate of the intestinal blood flow. In this report the authors suggest that the diagnosis of celiac artery compression should be considered in asymptomatic pediatric patients representing abdominal bruit or with palpated thrill in the upper epigastrium. In comparison with case reports present in the English-language literature, the patient reported on here is the youngest diagnosed.