Digestive Diseases and Sciences

, Volume 52, Issue 1, pp 302–305

Dunbar’s Syndrome and Superior Mesenteric Artery’s Syndrome: A Rare Association

  • Mario Sianesi
  • Paolo Soliani
  • Maria Francesca Arcuri
  • Lamia Bezer
  • Gioacchino Iapichino
  • Paolo Del Rio
Original Article
  • 108 Downloads

Abstract

Celiac artery compression syndrome (CACS) and superior mesenteric artery syndrome (SMAS) are 2 rare diseases, widely described in literature. Their association has not been specifically investigated; in fact, few cases have been reported. For this reason we reviewed our experience from January 1974 to June 2004. We report 59 patients affected by CACS and 28 by SMAS. Coexistence of both syndromes in 8 patients was observed. These 8 patients were successfully treated with duodenojejunal bypass and decompression of the celiac trunk. In this paper, we analyze the pathogenesis, clinical presentation, diagnosis, and treatment of these syndromes, emphasizing their common aspects. The misdiagnosis of this association may justify in some cases the controversial results reported regarding the surgical treatment of these syndrome.

Keywords

Celiac artery compression syndrome Angina abdominis Superior mesenteric artery syndrome Duodenal obstruction 

References

  1. 1.
    Pezza V, Prati R, Troiso A, Ferrari G (1987) Vascular compression of the duodenum associated with compression of the celiac axis. Minerva Chir 42:93–95PubMedGoogle Scholar
  2. 2.
    Akin JT, Gray SW, Skandalakis JE (1976) Vascular compression of the duodenum: presentation of ten cases and review of the literature. Surgery 79:515–522PubMedGoogle Scholar
  3. 3.
    Ahmed AR, Taylor I (1997) Superior mesenteric artery syndrome. Postgrad Med J 73:776–778PubMedGoogle Scholar
  4. 4.
    Lipshutz B (1917) A composite study of the celiac axis artery. Ann Surg 65:159–169PubMedCrossRefGoogle Scholar
  5. 5.
    Harjola PT (1963) A rare obstruction of the coeliac artery; report of a case. Ann Chir Gynecol Fenn 52:547–550Google Scholar
  6. 6.
    Dunbar DJ, Molnar N, Beman FF, Marable SA (1965) Compression of the celiac trunk and abdominal angina. Am J Roentgenol 95:731–744Google Scholar
  7. 7.
    Watson WC, Sadikali F (1977) Celiac axis compression: experience with 20 patients and a critical appraisal of the syndrome. Ann Intern Med 86:278–284PubMedGoogle Scholar
  8. 8.
    Takach TJ, Livesay JJ, Reul GJ, Cooley DA (1996) Celiac compression syndrome: tailored therapy based on intraoperative findings. J Am Coll Surg1 83:606–610Google Scholar
  9. 9.
    Loffeld RJ, Overtoom HA, Rauwerda JA (1995) The celiac axis compression syndrome. Report of 5 cases. Digestion 56:534–537PubMedCrossRefGoogle Scholar
  10. 10.
    Szilagyi DE, Rian RL, Elliott JP, Smith RF (1972) The celiac artery compression syndrome: does it exist? Surgery 72:849–863PubMedGoogle Scholar
  11. 11.
    Brandt LJ, Boley SJ (1978) Celiac axis compression syndrome. A critical review. Am J Dig Dis 23:633–640PubMedCrossRefGoogle Scholar
  12. 12.
    Thompson NW, Eckhauser FE, Talpos G, Cho KJ (1981) Pancreaticoduodenectomy and celiac occlusive disease. Ann Surg 193:399–406PubMedCrossRefGoogle Scholar
  13. 13.
    Jurim O, Shaked A, Kiai K, Millis JM, Colquhoun SD, Busuttil RW (1993) Celiac compression syndrome and liver transplantation. Ann Surg 218:10–12PubMedCrossRefGoogle Scholar
  14. 14.
    Botta GC, Villani LG, Dalla Valle R (199) La sindrome di Dunbar o del crocevia aorto-diaframmatico. Argomenti di Chirurgia 10:369–374Google Scholar
  15. 15.
    Rokitansky C (1861) Lehrbuch der pathologischen Anatomie. W. Braumuller, WienGoogle Scholar
  16. 16.
    Barner HB, Sherman CD (1963) Vascular compression of the duodenum. Int Abst Surg 117:103–118Google Scholar
  17. 17.
    Cimmino CV (1961) Arteriomesenteric occlusion of the duodenum: an entity? Radiology 76:828–829PubMedGoogle Scholar
  18. 18.
    Cimmino CV (1961) The status of the syndrome of arteriomesenteric occlusion of the duodenum. A critical review. Virginia Med Monthly 88:192–204PubMedGoogle Scholar
  19. 19.
    Curl JH, Thompson NW, Stanley JC (1971) Median arcuate ligament compression of the celiac and superior mesenteric arteries. Ann Surg 173:314–320PubMedCrossRefGoogle Scholar
  20. 20.
    Lawson JD, Ochsner JL (1984) Median arcuate ligament syndrome with severe two-vessel involvement. Arch Surg 119:226–227PubMedGoogle Scholar
  21. 21.
    Bech F, Loesberg A, Rosenblum J, Glagov S, Gewertz BL (1994) Median arcuate ligament compression syndrome in monozygotic twins. J Vasc Surg 19:934–938PubMedGoogle Scholar
  22. 22.
    Jones SA, Carter R, Smith LL, Joergenson EJ (1960) Arteriomesenteric duodenal compression. Am J Surg 100:262–277PubMedCrossRefGoogle Scholar
  23. 23.
    Wayne ER, Miller RE, Eiseman B (1971) Duodenal obstruction by the superior mesenteric artery in bedridden combat casualties. Ann Surg 174:339–345PubMedCrossRefGoogle Scholar
  24. 24.
    Haley JC, Peden JK (1943) The suspensory muscle of the duodenum. Am J Surg 59:546–555CrossRefGoogle Scholar
  25. 25.
    Burrington JD, Wayne ER (1974) Obstruction of the duodenum by the superior mesenteric artery—does it exist in children? J Pediatr Surg 9:733–741PubMedCrossRefGoogle Scholar
  26. 26.
    Ortiz C, Cleveland RH, Blickman JG, Jaramillo D, Kim SH (1990) Familial superior mesenteric artery syndrome. Pediatr Radiol 20:588–589PubMedCrossRefGoogle Scholar
  27. 27.
    Balaban DH, Chen J, Lin Z, Tribble CG, McCallum RW (1997) Median arcuate ligament syndrome: a possible cause of idiopathic gastroparesis. Am J Gastroenterol 92:519–523PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Mario Sianesi
    • 1
  • Paolo Soliani
    • 1
  • Maria Francesca Arcuri
    • 1
  • Lamia Bezer
    • 1
  • Gioacchino Iapichino
    • 1
  • Paolo Del Rio
    • 1
    • 2
  1. 1.Istituto di Clinica Chirurgica Generale e dei Trapianti d’Organo Università di ParmaParmaItaly
  2. 2.Department of Surgical ScienceUniversity of ParmaParmaItaly

Personalised recommendations