Celiac artery compression syndrome – a misnomer

Objectives: Celiac artery (CA) compression syndrome (CACS) is rarely diagnosed. Commonly known symptoms consist mainly of postprandial pain and weight loss. We review our experience in some 400 sonographically diagnosed patients.

Methods: In the last nine years the author performed >2000 color Doppler sonographic examinations of the abdomen in >9000 Patients (0–18 years). Diagnostic criteria of CACS were: flow acceleration in celiac artery above 200cm/s and relevant changes of flow velocity with in- and expiration

Results: 381 patients (286 girls) with celiac artery compression were detected among 8018 (prevalence 4,76%). Sonographic diagnosis was confirmed by MR or DS-angiography in 100% (n=24). 41% had no actual complaints – of the others 91% complained epigastric pain, 88% vegetative symptoms (fainting, dizziness, syncope, diarrhea), 34% precordial pain and 23% major breathing difficulties. Vegetative symptoms were very common and completely disappeared in 5 operated patients.

Conclusions: CACS is much more frequent then expected and can be reliably diagnosed by color Doppler sonography. It is a relevant cause of pain and vegetative symptoms. It is reasonable therefore to think over the name of the disease since vegetative symptoms can only be explained as mechanical alteration of the celiac ganglion instead compression of the celiac artery alone. Renaming the disease as “Celiac Ganglion Compression Syndrome“ is therefore proposed.