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Case Reports
. 2012 Aug 7;18(29):3917-20.
doi: 10.3748/wjg.v18.i29.3917.

Thrombosis of celiacomesenteric trunk: report of a case

Federico Lovisetto  1 , Gianbattista Finocchiaro De Lorenzi, Piera Stancampiano, Carmen Corradini, Fabio De Cesare, Orazio Geraci, Mario Manzi, Francesco Arceci
Affiliations
Case Reports

Thrombosis of celiacomesenteric trunk: report of a case

Federico Lovisetto et al. World J Gastroenterol. .

Abstract

Here we present the case of a 79-year-old woman who complained of acute abdominal pain, vomiting and diarrhoea. Laboratory exams demonstrated a severe metabolic imbalance. Abdominal X-rays showed bowel overdistension and pneumatosis of the stomach wall. Abdominal tomography revealed infarction of the stomach, duodenum and small bowel due to thrombosis of the celiacomesenteric trunk. Exploratory laparotomy revealed ischemia of the liver, spleen infarction and necrosis of the gastro-intestinal tube (from the stomach up to the first third of the transverse colon). No further surgical procedures were performed. The patient died the following day. To our knowledge, this is the first reported case about severe gastro-intestinal ischemia due to thrombosis of the celiacomesenteric trunk, a rare anatomic variation of the gastrointestinal vascularisation.

Keywords: Anomalies; Celiac trunk; Celiacomesenteric trunk; Gastrointestinal vascularisation; Thr-ombosis.

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Figures

Figure 1
Figure 1
Abdominal X-rays. Gaseous overdistension of the small bowel. The arrow points the pneumatosis of the stomach wall.
Figure 2
Figure 2
Computed tomography of the abdomen. A: Pneumatosis of the wall of stomach and small bowel (arrow in the right). Intraparenchimal air in ventral portions of the left liver and fourth segment (arrow in the left); air within the branches of the mesenteric vein (arrow in the centre); B:Thrombosis of the celiacomesenteric trunk (CMT) (arrow). In the detail: common origin of celiac trunk (CT) and superior mesenteric artery (SMA) from the CMT.
Figure 3
Figure 3
Primitive splanchnic vascularisation. Ventral longitudinal anastomosis (Lang’s anastomosis) between four primitive splanchnic roots arising from the abdominal aorta.
Figure 4
Figure 4
Celiacomesenteric trunk. Retention of the ventral longitudinal anastomosis higher than the fourth root keeps one or more celiac trunk branches with the superior mesenteric artery, disappearance of the first or fourth root causes a common celiacomesenteric trunk.
See this image and copyright information in PMC

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