Boukoucha Mabrouka, Yahmadi Abdelwahed, Znaidi Hakim, Ben Khelifa Raoudha, Daghfous Alifa
Department of Radiology, Trauma and BurnCenter of Ben Arous, Tunisia.
Department of Surgery, Trauma and Burn Center of Ben Arous, Tunisia.
Int J Surg Case Rep. 2020;71:128-131. doi: 10.1016/j.ijscr.2020.04.103. Epub 2020 May 21.
The celiacomesenteric trunk (CMT) is one of the most striking among the different variations of the normal vascularisation of the gastro-intestinal tract. It is often accidentally discovered during autoptical dissections, angiography or abdominal computed tomography (CT).
A 27-year-old man was admitted to emergency for an acute abdominal pain. For his critical condition, the patient was immediately brought to the operating room. A extensive intestinal necrosis was found. Post-operator CT discovered a common CMT that is complicated by extended thrombosis. Despite all resuscitation measures, the patient died of septic shock two days later. An autopsy was performed showed that the main cause of intestinal ischemia was related to dissection of a common CMT.
A CMT is a highly unusual variation in humans. It is usually asymptomatic and may be discovered incidentally during vascular surgery, radiologic imaging, or cadaver's dissection. Lesion of this entity can lead to serious gastrointestinal complications including necrosis. Different classifications are proposed in the literature.
As it is associated with the risk of mesenteric ischaemia, CMT should be kept in mind as a differential diagnosis for cases of recurrent non-specific abdominal pain.
腹腔肠系膜干（CMT）是胃肠道正常血管化不同变异中最显著的一种。它常在尸体解剖、血管造影或腹部计算机断层扫描（CT）时意外发现。
一名27岁男性因急性腹痛入院急诊。鉴于其危急状况，患者立即被送往手术室。发现广泛的肠坏死。术后CT发现一条合并广泛血栓形成的共同CMT。尽管采取了所有复苏措施，患者两天后死于感染性休克。尸检显示肠缺血的主要原因与一条共同CMT的夹层有关。
CMT在人类中是一种非常罕见的变异。它通常无症状，可能在血管手术、放射影像学检查或尸体解剖时偶然发现。该实体的病变可导致包括坏死在内的严重胃肠道并发症。文献中提出了不同的分类方法。
由于CMT与肠系膜缺血风险相关，对于复发性非特异性腹痛病例，应将其作为鉴别诊断予以考虑。
