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TÜRKÇE
Oral Presentation - 72
Diagnosis and treatment of celiac artery compression syndrome in children
Zorikto Mitupov 1, Alexander Razumovsky 1, Alena Shominova 1, Elena Titova 1, Victor Rachkov 2
1 Pirogov Russian National Research Medical University, Moscow, Russia
2 Pirogov Russian National Research Medical University
Objective: Improving treatment outcomes for patients with celiac artery compression syndrome (CACS).
Materials and methods. From 2021 to 2024, 132 patients with CACS aged 4 to 17 years were operated. Combined pathology of the upper GI was diagnosed in 50 (37.8%) patients. Following data were evaluated: anamnesis, complaints, Doppler ultrasound, angiography, esophagogastroscopy and barium esophagram. GERD was detected in 34 patients, chronic duodenal obstruction in 2, and a combination of the two in 14. According to angiography (107 studies), the patients were divided into 2 groups. Group I consisted of 31 patients (28.9%) without collateral blood flow and group II consisted of 76 patients (71.1%) who with collateral blood flow. The surgical intervention consisted of laparoscopic dissection of the median arcuate ligament of the diaphragm.
Results. In a comparative analysis of the 2 groups, abdominal pain syndrome was 4 times more common in patients with celiac artery disease without compensatory circulation (p<0.05). Pain relief was noted in more than 80% of patients after celiac artery dissection (p<0.001). Decrease in the velocity in the celiac artery to normal values was noted (Me (before surgery) = 272.5 cm/sec, Me (after surgery) = 170 cm/sec, p<0.001). The average duration of the laparoscopic surgery was 48.6 minutes. Conversion was performed in 2 cases due to bleeding. There were no fatal outcomes. Simultaneous surgeries for combined pathology were performed in 36 patients.
Conclusion. CACS is a rare pathology with a non-specific clinical picture, which should be considered after excluding other causes of abdominal pain. Angiography is the method of choice in diagnosing CACS. Pain relief in patients with CACS after surgery is achieved in more than 80% of cases. When detecting combined pathology of the upper GI with CACS, their simultaneous correction is preferable.