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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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Minerva Gastroenterologica e Dietologica 2007 June;53(2):209-13

language: English

Chronic abdominal pain associated with intermittent compression of the celiac artery

Marcoccia A. 1, Zippi M. 2, Bruni A. 3, Salvatori F. M. 4, Badiali D. 5, Donato G. 5, Picarelli A. 5

1 Unit of Angiology Sandro Pertini Hospital, Rome, Italy
2 Unit of Gastroenterology and Digestive Endoscopy Sandro Pertini Hospital, Rome, Italy
3 Unit of Radiology Sandro Pertini Hospital, Rome, Italy
4 Department of Radiological Sciences La Sapienza University, Rome, Italy
5 Department of Clinical Sciences La Sapienza University, Rome, Italy


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Recurrent abdominal pain (RAP), surely one of the most frequent causes of medical intervention, is frequently present in many gastrointestinal disease. Usually no structural and/or biochemical alterations can be demonstrated. This condition is, therefore, considered to be due to functional disorders such as irritable bowel syndrome (IBS) or functional dyspepsia. Previous observations suggest the presence of a rare alteration of celiac vessels among the possible causes of RAP. This pathological condition was known as Dunbar syndrome. We report 2 cases of chronic abdominal pain. The former reported weight loss and the latter anemia with iron deficiency. It is remarkable that patients with initial diagnosis of IBS can be affected by celiac disease (CD), which is the cause of their abdominal pain. Our patients were tested for CD; the former was negative and IBS was diagnosed, the latter was positive and a gluten free diet was prescribed. The presence of an epigastric bruit, accentuated during expiration, suggested a possible vascular alteration known as tripod celiac artery compression syndrome. Duplex Doppler sonography suggests the diagnosis of celiac arterial constriction due the diaphragmatic ligament. These cases show that tripod celiac artery compression syndrome might be a cause of RAP and that it may be evaluated and investigated when the clinical examination discloses an abdominal systolic bruit.

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