Síndrome de Dunbar - relato de caso
Dunbar syndrome - case report
Sarah Maria Lemos de Campos; Rafael Prado Pessoa; João Paulo de Araújo Pelegrini; Henrique Fernandes Silveira; Maria Fernanda Lopes Diniz; Maria Passos Bianchini; Leonardo Soares Lopes; Marcus Eduardo Valadares Meireles Martins da Costa
Resumo
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Abstract
Dunbar syndrome is diagnosed by excluding other possible causes of abdominal pains. Surgical treatment comprises complete dissection of the ligament and the surrounding nerve ganglion. This report describes the case of a previously healthy 45-year-old male patient who presented with epigastric abdominal pain irradiating to the back and weakness. Initially, abdominal computed tomography was ordered, showing arteriopathy of the celiac trunk and mesenteric artery with stenosis. The patient underwent surgical treatment because of the refractory pain, but findings were nonspecific. It was necessary to continue workup with serial angiotomography to follow the case. After around 6 months, thickening of the arcuate ligament was found, with compression of the proximal third of the celiac trunk and 80% stenosis. The patient therefore underwent laparoscopy to relieve celiac trunk compression, with satisfactory postoperative recovery.
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References
1 Loukas M, Pinyard J, Vaid S, Kinsella C, Tariq A, Tubbs RS. Clinical anatomy of celiac artery compression syndrome: a review. Clin Anat. 2007;20(6):612-7.
2 Jimenez JC, Harlander-Locke M, Dutson EP. Open and laparoscopic treatment of median arcuate ligament syndrome. J Vasc Surg. 2012;56(3):869-73.
3 Dunbar JD, Molnar W, Beman FF, Marable SA. Compression of the celiac trunk and abdominal angina. Am J Roentgenol Radium Ther Nucl Med. 1965;95(3):731-44.
4 Gagnier JJ, Riley D, Altman DG, Moher D, Sox H, Kienle GS. The CARE guidelines: consensus-based clinical case reporting guideline development. Dtsch Arztebl Int. 2013;110(37):603-8.
5 Santos GM, Viarengo LMA, Oliveira MDP. Celiac artery compression: Dunbar syndrome. J Vasc Bras. 2019;18:8.
6 Kim EN, Lamb K, Relles D, Moudgill N, DiMuzio PJ, Eisenberg JA. Median arcuate ligament syndrome-review of this rare disease. JAMA Surg. 2016;151(5):471-7.
7 Paz Z, Rak Y, Rosen A. Anatomical basis for celiac trunk and superior mesenteric artery entrapment. Clin Anat. 1991;4(4):256-64.
8 Weber JM, Boules M, Fong K, et al. Median arcuate ligament syndrome is not a vascular disease. Ann Vasc Surg. 2016;30:22-7.
9 Baskan O, Kaya E, Gungoren FZ, Erol C. Compression of the celiac artery by the median arcuate ligament: multidetector computed tomography findings and characteristics. Can Assoc Radiol J. 2015;66(3):272-6.
10 Horton KM, Talamini MA, Fishman EK. Median arcuate ligament syndrome: evaluation with CT angiography. Radiographics. 2005;25(5):1177-82.
11 França LHG, Mottin C. Surgical treatment of Dunbar syndrome. J Vasc Bras. 2013;12(1):57-61.
12 Trinidad-Hernandez M, Keith P, Habib I, White JV. Reversible gastroparesis: functional documentation of celiac axis compression syndrome and postoperative improvement. Am Surg. 2006;72(4):339-44.
Submitted date:
02/27/2023
Accepted date:
05/04/2023
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