A young patient with concurrent splanchnic dynamic vascular compression syndromes

Simple item page
dc.contributor.authorGeorge Salem
dc.contributor.authorAna I Casanegra
dc.contributor.authorJoshua L Gierman
dc.contributor.authorBeau M Hawkins
dc.contributor.authorAlfonso J Tafur
dc.date.accessioned2017-03-06T23:47:33Z
dc.date.available2017-03-06T23:47:33Z
dc.date.issued2015-04-15
dc.description.abstractA thirty-year-old lady presented with chronic, postprandial abdominal pain associated with decreased appetite and weight loss. She had a past medical history of ulcerative colitis and past surgical history of Nissen fundoplication, hysterectomy and bilateral oophorectomy for endometriosis. Enhanced computed tomography (CT) of the abdomen/pelvis displayed severe narrowing of the celiac artery (CA) at the level of its ostium (Panel A) with post-stenotic dilatation. In an abdominal vascular ultrasound with respiratory maneuvers we saw a peak systolic velocity (PSV) in the CA during inspiration of 295 cm/s. The PSV was 108 cm/s during expiration for the CA. Peak systolic velocity in the superior mesenteric artery (SMA) was 424 cm/s during inspiration. Magnetic resonance angiogram (MRA, Panel B) showed compression of the SMA with post-stenotic dilatation. No signs of perivascular inflammation or fat stranding were appreciated. Serology studies workup showed only weakly positive anti nuclear antibody (ANA) titer. A mesenteric angiography (Panels C and D) illustrated progression to occlusion of the CA, a dynamic compression of the SMA with kinking mainly during expiration, and post-stenotic dilatation. The pre-operative suspicion for dynamic mesenteric vascular compression syndromes was intra-operatively confirmed with associated scarring along the CA and SMA via the arcuate ligament.
dc.description.peerreviewYesen_US
dc.description.peerreviewnoteshttps://us.sagepub.com/en-us/nam/manuscript-submission-guidelinesen_US
dc.identifier.doi10.1177/1358863X15578727en_US
dc.identifier.urihttp://hdl.handle.net/11244/49350
dc.language.isoen_USen_US
dc.publisherVascular Medicine
dc.relation.urihttp://journals.sagepub.com/doi/full/10.1177/1358863X15578727
dc.rights.requestablefalseen_US
dc.titleA young patient with concurrent splanchnic dynamic vascular compression syndromesen_US
dc.typeOtheren_US

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
10.1177.1358863X15578727.pdf
Size:
448.32 KB
Format:
Adobe Portable Document Format
Download

Collections

OU - Faculty and Staff Publications