Laparoscopic Treatment of Celiac Artery Compression Syndrome: Case Series and Review of Current Treatment Modalities

Abstract

IntroductionCompression of the celiac artery by the diaphragmatic crura, the median arcuate ligament, or the fibrous periaortic ganglionic tissue results in a rare constellation of symptoms known as celiac artery compression syndrome (CACS). AnatomyFirst described in 1963 by Harjola in a patient with symptoms of mesenteric ischemia, it remains an elusive diagnosis. Clinical PresentationPatients commonly present with a wide variety of symptoms resulting in multiple diagnostic tests. DiagnosisA firm diagnosis is difficult to establish, and treatment is equally challenging. These challenges are illustrated by the following case series, and evidence supporting current treatment modalities is reviewed. TreatmentWe describe a laparoscopic approach to decompression of the celiac artery facilitated by intraoperative ultrasound.