Document Detail

Celiac artery compression syndrome in children, adolescents, and young adults: clinical and color duplex sonographic features in a series of 59 cases.
MedLine Citation:
PMID:  16495489     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Abdominal pain is one of the most common conditions in childhood and adolescence. Celiac artery compression syndrome (CACS) is rarely suspected in this population. We present clinical and sonographic features from a series of 59 patients with this disorder. METHODS: A total of 3449 patients from 0 to 18 years were investigated with 7639 abdominal color duplex sonographic examinations. Celiac artery flow velocity was measured at the branching off from the aorta in inspiration, expiration, and in between. Diagnosis of CACS was made if a greater than 2-fold acceleration of peak systolic flow in the celiac artery compared to the abdominal aorta or a peak systolic velocity greater than 200 cm/s was measured in the mid position and if a variation of flow velocity occurred during respiration. In 22 cases, angiography (21 magnetic resonance angiography and 1 digital subtraction angiography) was used to prove sonographic diagnosis. RESULTS: Fifty-nine patients (among them 81% female) from 22 months to 19 years (clustering between 14 and 17 years) fulfilling color Doppler sonographic criteria of CACS were found, for a prevalence of 1.7%. Their symptoms included, among others, abdominal pain (71%), nausea (29%), thoracic pain (22%), heartburn (17%), weight loss (15%), vomiting (15%), systolic murmur (15%), postprandial accentuation of symptoms (15%), diarrhea (14%), respiratory discomfort (14%), and syncope (12%). CONCLUSIONS: Celiac artery compression syndrome is more prevalent than expected, and conditions not usually connected to the disease were found. Alertness to CACS is recommended, especially in patients with a combination of characteristic symptoms. Color Doppler sonography is the modality of choice for diagnosing CACS.
Thomas Scholbach
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  25     ISSN:  0278-4297     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-23     Completed Date:  2006-08-03     Revised Date:  2006-12-07    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-305     Citation Subset:  IM    
Municipal Children's Hospital St Georg, Leipzig, Germany.
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MeSH Terms
Abdominal Pain / etiology
Blood Flow Velocity / physiology
Celiac Artery / physiopathology,  radiography,  ultrasonography*
Child, Preschool
Constriction, Pathologic / diagnosis,  epidemiology,  physiopathology
Diagnosis, Differential
Ultrasonography, Doppler, Color / methods*
Vascular Diseases / diagnosis*,  epidemiology,  physiopathology
Comment In:
J Ultrasound Med. 2006 Aug;25(8):1108; author reply 1108-9   [PMID:  16870909 ]

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