Celiac trunk compression syndrome requiring surgery in 3 adolescent patients

Abstract

Background/methods: Celiac trunk compression syndrome is a rare cause of recurrent, nonspecific upper abdominal pain. In this article, we present 3 cases of celiac trunk compression syndrome in 15- and 16-year-old adolescents who were treated surgically in our clinic and discuss our findings with existing literature.

Results: All 3 adolescents complained about unspecific upper gastrointestinal pain. The performance of digital subtraction angiography and, accordingly, magnetic resonance angiography showed, respectively, a stenosis and an occlusion of the celiac artery. In all cases, a decompression of the celiac trunk as well as a resection of the celiac plexus in the region near the outlet of the trunk was performed. Patients have been surveyed between 12 and 18 months postoperatively. In all cases, the gastrointestinal symptoms have completely disappeared.

Discussion: Celiac artery compression syndrome is understood to consist of symptoms of recurrent pain, caused by a neurovascular narrowing of the aortic hiatus and celiac trunk. The surgical approach of choice is sharp transection of the median arcuate ligament, along with complete resection of the nerve fibers of the celiac plexus with or without performance of revascularisation. In summary, celiac trunk compression syndrome is a rare cause of recurrent epigastric pain that should be not be ignored completely as a differential diagnosis.