Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011 Sep;20(3):181-4.
doi: 10.1055/s-0031-1284202.

Mysterious abdominal pain

Alberto Cappelletti  1 , Nicole Cristell, Monica Mazzavillani, Alberto Margonato
Affiliations
Case Reports

Mysterious abdominal pain

Alberto Cappelletti et al. Int J Angiol. 2011 Sep.

Abstract

A man presented to the emergency room with recurrent episodes of abdominal pain. He had a history of coronary artery bypass grafting of the left internal mammary artery (LIMA) to the left anterior descending (LAD) artery and the right gastroepiploic artery to the posterior descending artery. After numerous gastrointestinal evaluations, a stress test was performed, which was positive. Coronary angiography showed a proximal occlusion of the LAD and right coronary artery and a normal functioning LIMA bypass. Aortography showed a 95% stenosis of the celiac trunk. Angioplasty and stent implantation of the celiac trunk was successfully performed. Six months later the patient was completely asymptomatic with a negative stress test. In conclusion, abdominal pain in patients who have undergone coronary artery bypass surgery using the right gastroepiploic artery should raise suspicion not only of a stenosis of the arterial conduit but also of a potential stenosis of the celiac trunk.

Keywords: Abdominal pain; angioplasty; celiac trunk; coronary artery bypass grafting; right gastroepiploic artery; stent implantation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Abdominal angiography (left lateral view) showing severe stenosis of the celiac trunk (arrow).
Figure 2
Figure 2
Angiographic result at the end of the procedure (arrow).
See this image and copyright information in PMC

References

    1. Heading R C. Prevalence of upper gastrointestinal symptoms in the general population: a systematic review. Scand J Gastroenterol Suppl. 1999;231:3–8. - PubMed
    1. Matsunaga S, Eguchi Y. Importance of a physical examination for efficient differential diagnosis of abdominal pain: diagnostic usefulness of Carnett's test in psychogenic abdominal pain. Intern Med. 2011;50(3):177–178. - PubMed
    1. Vaezi M F. Reflux monitoring: on or off therapy? Am J Gastroenterol. 2011;106(2):183–185. - PubMed
    1. Loyd R A, McClellan D A. Update on the evaluation and management of functional dyspepsia. Am Fam Physician. 2011;83(5):547–552. - PubMed
    1. Chang J Y, Talley N J. An update on irritable bowel syndrome: from diagnosis to emerging therapies. Curr Opin Gastroenterol. 2010;27(1):72–78. - PubMed

Publication types