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Clinical and Radiologic Review of Uncommon Cause of Profound Iron Deficiency Anemia: Median Arcuate Ligament Syndrome

  • 투고 : 2013.07.16
  • 심사 : 2014.03.04
  • 발행 : 2014.07.01

초록

Median arcuate ligament syndrome is an anatomic and clinical entity characterized by dynamic compression of the proximal celiac artery by the median arcuate ligament, which leads to postprandial epigastric pain, vomiting, and weight loss. These symptoms are usually nonspecific and are easily misdiagnosed as functional dyspepsia, peptic ulcer disease, or gastropathy. In this report, we presented a 72-year-old male patient with celiac artery compression syndrome causing recurrent abdominal pain associated with gastric ulcer and iron deficiency anemia. This association is relatively uncommon and therefore not well determined. In addition, we reported the CT angiography findings and three-dimensional reconstructions of this rare case.

키워드

참고문헌

  1. Bech FR. Celiac artery compression syndromes. Surg Clin North Am 1997;77:409-424 https://doi.org/10.1016/S0039-6109(05)70558-2
  2. Stein JJ, Costanza MJ, Rivero M, Gahtan V, Amankwah KS. External compression of the superior mesenteric artery by the median arcuate ligament. Vasc Endovascular Surg 2011;45:565-567 https://doi.org/10.1177/1538574411412827
  3. Gander S, Mulder DJ, Jones S, Ricketts JD, Soboleski DA, Justinich CJ. Recurrent abdominal pain and weight loss in an adolescent: celiac artery compression syndrome. Can J Gastroenterol 2010;24:91-93 https://doi.org/10.1155/2010/534654
  4. Horton KM, Talamini MA, Fishman EK. Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics 2005;25:1177-1182 https://doi.org/10.1148/rg.255055001
  5. Patten RM, Coldwell DM, Ben-Menachem Y. Ligamentous compression of the celiac axis: CT findings in five patients. AJR Am J Roentgenol 1991;156:1101-1103 https://doi.org/10.2214/ajr.156.5.2017934
  6. Duffy AJ, Panait L, Eisenberg D, Bell RL, Roberts KE, Sumpio B. Management of median arcuate ligament syndrome: a new paradigm. Ann Vasc Surg 2009;23:778-784 https://doi.org/10.1016/j.avsg.2008.11.005
  7. Balaban DH, Chen J, Lin Z, Tribble CG, McCallum RW. Median arcuate ligament syndrome: a possible cause of idiopathic gastroparesis. Am J Gastroenterol 1997;92:519-523
  8. Marcoccia A, Zippi M, Bruni A, Salvatori FM, Badiali D, Donato G, et al. Chronic abdominal pain associated with intermittent compression of the celiac artery. Minerva Gastroenterol Dietol 2007;53:209-213
  9. Mizokami A, Matsuoka N, Fukae S, Sato K, Murakami S, Uchida Y. [A case report of drug-resistant gastric ulcer caused by celiac axis compression syndrome]. Nihon Shokakibyo Gakkai Zasshi 1992;89:1297-1299
  10. Sturiale A, Alemanno G, Giudici F, Addasi R, Bellucci F, Tonelli F. Median Arcuate Ligament Syndrome in a patient with Crohn's disease. Int J Surg Case Rep 2013;4:399-402 https://doi.org/10.1016/j.ijscr.2013.01.015
  11. Carbonell AM, Kercher KW, Heniford BT, Matthews BD. Multimedia article. Laparoscopic management of median arcuate ligament syndrome. Surg Endosc 2005;19:729 https://doi.org/10.1007/s00464-004-6010-x
  12. Scholbach T. Celiac artery compression syndrome in children, adolescents, and young adults: clinical and color duplex sonographic features in a series of 59 cases. J Ultrasound Med 2006;25:299-305 https://doi.org/10.7863/jum.2006.25.3.299
  13. Grotemeyer D, Duran M, Iskandar F, Blondin D, Nguyen K, Sandmann W. Median arcuate ligament syndrome: vascular surgical therapy and follow-up of 18 patients. Langenbecks Arch Surg 2009;394:1085-1092 https://doi.org/10.1007/s00423-009-0509-5
  14. Karahan OI, Kahriman G, Yikilmaz A, Ok E. Celiac artery compression syndrome: diagnosis with multislice CT. Diagn Interv Radiol 2007;13:90-93
  15. Kopecky KK, Stine SB, Dalsing MC, Gottlieb K. Median arcuate ligament syndrome with multivessel involvement: diagnosis with spiral CT angiography. Abdom Imaging 1997;22:318-320 https://doi.org/10.1007/s002619900199
  16. Reuter SR, Redman HC, Cho KJ. Gastrointestinal angiography, 3rd ed. Philadelphia, PA: Saunders, 1986:105-107