From the Research
Introduction
The celiac axis, also known as the celiac trunk, is a vital artery that arises from the abdominal aorta and supplies blood to the stomach, liver, and other abdominal organs. A marked change in the angulation of the celiac axis can have significant implications for patient health and treatment outcomes.
Anatomical Variations
Studies have shown that anatomical variations of the celiac axis are common, with one study finding that 36.1% of patients had variant types of arterial anatomy 1. These variations can include changes in the origin of the celiac axis, as well as variations in the branching pattern of the artery. For example, one study found that the right hepatic artery originated from the superior mesenteric artery in 9.6% of patients, and from the celiac axis in 1.8% of patients 1.
Clinical Significance
A marked change in the angulation of the celiac axis can be a sign of celiac artery compression syndrome (CACS), a rare disorder that results from compression of the celiac artery by the median arcuate ligament 2. CACS can present with symptoms such as post-prandial abdominal pain, weight loss, and an abdominal bruit. Imaging modalities such as computed tomography angiography and mesenteric vascular duplex can help diagnose CACS.
Diagnosis and Treatment
Diagnosis of CACS typically involves imaging studies such as computed tomography angiography, which can reveal a characteristic "hook" or "J" shape of the celiac axis 3, 2. Treatment of CACS usually involves surgical decompression via division of the median arcuate ligament, which can provide significant and long-lasting relief from symptoms 2.
Differential Diagnosis
A marked change in the angulation of the celiac axis can also be caused by other factors, such as atherosclerosis or extrinsic compression by other structures. A thorough diagnostic workup is necessary to determine the underlying cause of the angulation change.
Caveats
It is essential to note that a "hook" or "J" shape of the celiac axis is not always a sign of CACS, as this shape can also be a normal anatomical variation 3. Additionally, CACS can be a challenging diagnosis to make, and a high index of suspicion is necessary to diagnose this condition.
Conclusion
In conclusion, a marked change in the angulation of the celiac axis can have significant clinical implications, and a thorough diagnostic workup is necessary to determine the underlying cause. Anatomical variations of the celiac axis are common, and knowledge of these variations is essential for accurate diagnosis and treatment of patients with celiac axis abnormalities.