Pancreatoduodenectomy co-morbid with celiac axis compression syndrome: a report of three cases

• Main Authors: Katsuki Miyazaki, Yuji Morine, Yu Saito, Shinichiro Yamada, Kazunori Tokuda, Tetsuya Ikemoto, Satoru Imura, Mitsuo Shimada
• Format: Article
• Language: English
• Published: SpringerOpen 2020-05-01
• Series: Surgical Case Reports
• Subjects: Pancreatoduodenectomy (PD); Celiac axis compression syndrome (CACS); Median arcuate ligament syndrome (MALS); Gastroduodenal artery (GDA)
• Online Access: http://link.springer.com/article/10.1186/s40792-020-00878-x

Abstract Background Celiac axis compression syndrome (CACS) is a relatively rare disease. Because of the nature of the blood flow in the celiac region when a pancreatoduodenectomy (PD) is performed for CACS, the celiac region can become ischemic. The aim of this study is to report on the importance of pre-operative diagnosis of CACS in terms of the outcomes for patients post-operatively. In this study, three 3 cases of PD co-morbid with CACS are reported: one intra-operative diagnosis case and two pre-operative diagnosis cases. Case presentation The one case, not diagnosed with CACS prior to the operation, had a hard post-operative course because of complication caused by ischemia of the celiac region compared with the two cases diagnosed prior to the operation, who had a good post-operative course because of pre-operative or intra-operative intervention. Conclusions Post-operative complications due to CACS are preventable by pre-operative diagnosis and appropriate interventions.