Schöller Andrea, Sugár István, Szeberin Zoltán, Ondrejka Pál, István Gábor, Vörös Attila
Semmelweis Egyetem II. Sz. Sebészeti Klinika Budapest.
Semmelweis Egyetem Érsebészeti Tanszék Budapest.
Magy Seb. 2014 Jun;67(3):99-102. doi: 10.1556/MaSeb.67.2014.3.4.
The authors report a case of a 34-year-old woman who had postprandial abdominal pain for years. During the course of her examination lactose intolerance and hiatus hernia was diagnosed. After ineffective conservative treatment CT angiography (CTA) and digital substraction angiography (DSA) was performed and showed significant celiac artery stenosis. Percutaneous transluminal angioplasty (PTA) was unsuccessful as extravasal mechanical compression was present, therefore, laparoscopic decompression and surgical division of MAL fibres were carried out. The postoperative period was characterized by a complete relief of previous symptoms and repeated CTA showed normal blood flow.
The authors emphasize the importance of the measurement of peak velocity of celiac trunk with Colour Duplex abdominal ultrasonography, the examination has 100% sensitivity and 83% specificity. The Duplex ultrasonography is less expensive than the "gold standard" diagnostic methods like CT and DS angiography, and can lead us to early diagnosis. Laparoscopic surgery is safe and low expense method for celiac artery decompression, however, sometimes it is difficult to reveal the exact reason and thus setting up the proper operation plan.
作者报告了一例34岁女性，该患者多年来一直有餐后腹痛症状。在检查过程中，诊断出乳糖不耐受和食管裂孔疝。在保守治疗无效后，进行了CT血管造影（CTA）和数字减影血管造影（DSA），结果显示腹腔干存在明显狭窄。由于存在血管外机械压迫，经皮腔内血管成形术（PTA）未成功，因此，进行了腹腔镜减压和MAL纤维的手术分离。术后之前的症状完全缓解，重复CTA显示血流正常。
作者强调了用彩色双功腹部超声测量腹腔干峰值流速的重要性，该检查具有100%的敏感性和83%的特异性。双功超声比CT和DS血管造影等“金标准”诊断方法成本更低，且能使我们早期诊断。腹腔镜手术是一种安全且低成本的腹腔动脉减压方法，然而，有时很难找出确切原因，从而制定出合适的手术方案。
