My what is what? Celiac Artery Compression Syndrome?
September 13, 2011 7:26 PM   Subscribe

Anyone have experience with Celiac Artery Compression Syndrome? (otherwise known as Dubar Syndrome, Marable Syndrome or Celiac Axis Compression Syndrome)

After much testing my doctor seems to be arriving at this. I can't find anything written in plain English about it. It started out with frequent nausea, some pain, then pancreatitis then progressed to pretty much guaranteed pain with every meal or beverage. It's getting so it hurts too much to walk after a meal. I've had just about every GI test you can name and then some and none have shown anything abnormal. I am supposed to have my gallbladder taken out next week, however, my surgeon recommended an ultrasound of the celiac artery be done today. This test had an abnormality. They have found evidence of compression and I am being asked to get an MRA very soon. This thing is so rare I can't find very much information. I was really hoping to find discussion boards from folks who have had it and what their experience was before and after surgery. (Also--this has nothing to do with celiac disease despite the word they have in common.) Thanks in advance.
posted by i_love_squirrels to Health & Fitness (2 answers total) 2 users marked this as a favorite
 
Try Medline Plus, the web site of the National Library of Medicine. You can browse through their links and find a lot of easy to comprehend information written by doctors on many medical conditions. None of the information is for profit spirited, just informational and reliable.
posted by effluvia at 8:10 PM on September 13, 2011


I can't find anything written in plain English about it.

I can't help with the before-and-after-surgery experience, but I can translate some of the readily-available med-speak on the internet into plain English for you.

GENERAL INFO

Celiac artery compression syndrome happens when the artery to the upper digestive system is squished by tissues that hold the diaphragm in place. To explain:

Your diaphragm is a big, flat muscle that allows you to breathe, and (to oversimplify a bit) it basically stretches across your entire body at the bottom of your ribs, front to back and side to side. Like if you cut yourself in half with a dinner plate, that plate is where your diaphragm sits.

The trouble is, your heart that pumps blood is above the diaphragm, and a lot of your body that needs blood (organs, legs, etc.) are below the diaphragm. To allow blood to get back and forth to your bottom half, there's a hole in the diaphragm where the piping can pass through (piping = arteries and veins).

In the case of celiac artery compression syndrome, the hole is too tight. Arteries are soft like rubber tubing, not stiff like metal pipes, so the celiac artery gets squished as it passes through this hole. If you squeeze a rubber tube, you can't get as much water to flow through it. Similarly, when the celiac artery is compressed, it slows the flow of blood through the artery. And all the organs downstream who are counting on that blood get mad. Your stomach, liver, spleen, pancreas, and parts of your small intestine need blood for oxygen and nutrients, but they can't get enough because the supply is reduced. Think of the pain in your tummy as your organs complaining, "Hey, we're not getting enough blood down here!!!"

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UpToDate is a very highly-respected reference for medical professionals. Their article on celiac artery compression syndrome, in plain English, basically says this:

CACS is a rare condition. The usual symptoms are pain in the belly after eating, and weight loss. Sometimes a doctor can hear a sound called a bruit when listening to the belly with a stethoscope. This sound is caused by the turbulent flow of blood in the compressed artery, like how a stream with lots of waves and swirls is noisier than a stream that flows smoothly.

We don't know why some people have this compression and pain, but there seems to be a genetic link. That is, the problem may run in families.

There is even still some confusion about whether the pain is really caused by a compressed celiac artery! There are alternate routes for the blood to take ("collateral circulation" = several arteries that all bring blood to the same place), so some doctors and researchers don't think the reduced circulation is enough to cause pain. They think the real problem might be in the splanchnic nerve plexus, which is a bundle of nerves that goes through the same hole in the diaphragm near the celiac artery. The confusion gets deeper, because we also know that many people have a compressed celiac artery without pain or problems. Why does the compression bother some people but not others? We don't know.

Surgery to fix the compression sometimes fixes the pain, and sometimes does not.

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Hope that was helpful. Good luck finding more information. I think it would be worth asking your surgeon whether s/he has done the proposed surgery before, and how many of his previous patients found their problems relieved after surgery. From what I've been reading, it sounds like the surgery works great for some people and not so well for others.
posted by vytae at 9:36 AM on September 14, 2011


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