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Case Reports
. 2019 May 23:18:e20180094.
doi: 10.1590/1677-5449.009418.

Celiac artery compression: Dunbar syndrome

Giovanna Mezzalira Santos  1 , Luiz Marcelo Aiello Viarengo  1 , Marcos Danillo Peixoto Oliveira  1   2
Affiliations
Case Reports

Celiac artery compression: Dunbar syndrome

Giovanna Mezzalira Santos et al. J Vasc Bras. .

Abstract
in English, Portuguese

Celiac artery compression syndrome, also referred to as median arcuate ligament syndrome, celiac axis syndrome or Dunbar syndrome is a rare disorder consequent to extrinsic compression of the celiac trunk by the median arcuate ligament. Doppler ultrasound, multi-slice computed tomography angiography, magnetic resonance angiography, or invasive selective angiography can identify stenosis of the initial segment of the celiac artery and confirm diagnosis. Treatment options include open surgical or videolaparoscopic section of the median arcuate ligament and the fibers of the celiac plexus, or percutaneous transluminal angioplasty via an endovascular approach. We report herein an interesting case of a 38-year-old woman diagnosed with this rare condition and successfully treated with the surgical strategy.

A síndrome da compressão da artéria celíaca, também denominada síndrome do ligamento arqueado mediano, síndrome do eixo celíaco ou síndrome de Dunbar, é uma doença rara causada pela compressão extrínseca do tronco celíaco pelo ligamento arqueado mediano. Ultrassonografia Doppler, angiotomografia computadorizada, angiorressonância magnética ou angiografia seletiva invasiva conseguem identificar a estenose do segmento inicial da artéria celíaca e confirmar o diagnóstico. As opções de tratamento incluem secção videolaparoscópica ou laparotômica (a céu aberto) do ligamento arqueado mediano e das fibras do plexo celíaco, assim como angioplastia transluminal percutânea. Relatamos o interessante caso de uma mulher de 38 anos de idade diagnosticada com essa rara condição e adequadamente tratada pela estratégia cirúrgica.

Keywords: Dunbar syndrome; celiac artery compression syndrome; median arcuate ligament syndrome.

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Conflict of interest statement

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Figures

Figure 1
Figure 1. US images showing end-expiratory (right panel) compression of the CT. Left panel, at rest; central panel, with deep inspiration; right panel, with deep expiration. CT = celiac trunk; SMA = superior mesenteric artery; EXP = expiration.
Figure 2
Figure 2. Multi-slice computed angiotomography with respiratory maneuvers - inspiration (left panels) and expiration (right panels). The typical hook-like downward stenosis of the celiac artery is due to the extrinsic compression by the arcuate ligament, especially at deep end expiration (right superior and inferior panels).
Figure 3
Figure 3. Postoperative multi-slice computed angiotomography with respiratory maneuvers - inspiration (left panels) and expiration (right panels) showing decompression of the celiac trunk.
See this image and copyright information in PMC

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