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Case Reports
. 2023 Feb 23;59(3):442.
doi: 10.3390/medicina59030442.

Persistence of Abdominal Pain: Did You Check for Mesenteric Vessels?

Jessica Piroddu  1 , Maria Pina Dore  1   2 , Giovanni Mario Pes  1 , Pier Paolo Meloni  3 , Giuseppe Manzoni  1
Affiliations
Case Reports

Persistence of Abdominal Pain: Did You Check for Mesenteric Vessels?

Jessica Piroddu et al. Medicina (Kaunas). .

Abstract

The incidence of abnormalities regarding the celiac-mesenteric trunk (CMT) has been reported to be between 1% and 2.7%, whereas for visceral aneurysms the incidence is between 0.1% and 0.2% of the general population. Anatomical variations in the CMT may be the result of abnormal embryogenesis of the primitive segmental splanchnic arteries that supply the bowel and several abdominal organs. The clinical presentation may range from vague abdominal symptoms to aneurysm rupture with a significant mortality risk. In this case, we describe the clinical history of a 37-year-old man with postprandial abdominal pain likely related to the celiac-mesenteric trunk enlargement, associated with high resistance flow in the proximal site. Postprandial symptoms improved by avoiding large meals and surveillance for the CMT anomalies was recommended by cross-imaging including the echo-color-Doppler to assess blood flow modification.

Keywords: aneurysms; celiac-mesenteric trunk; vessel abnormalities.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The celiac-mesenteric trunk observed by an ultrasound scan of the abdomen, indicating the size of the proximal and distal site.
Figure 2
Figure 2
The computer tomography scan confirmed the agenesis of the left hepatic lobe, splenomegaly, and an enlarged celiac-mesenteric trunk (red arrow).
Figure 3
Figure 3
In the 3D reconstruction of CT scan images, the enlarged celiac-mesenteric trunk can be observed indicated by a black arrow.
Figure 4
Figure 4
The echo-color-Doppler detected a high resistance flow in the proximal site of the celiac-mesenteric trunk, usually ranging from systolic velocity peaks between 90–100 cm/s (PSV); 30–65 cm/s end diastolic velocity peaks (EDV); and a pulsatility index (PI) of 1.5 ± 0.02.
See this image and copyright information in PMC

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