Poster Author of 2 e-Posters
EE-002 - Median arcuate ligament syndrome: A chronic mesenteric ischemia mimic, easily diagnosed with CTA
SE-021 - The role of CT guided percutaneous cholecystostomy for high risk surgical patients with acute cholecystitis and optimal timing of surgical cholecystectomy after the procedure: Α retrospective study in a single centre.
Author of 2 Presentations
EE-002 - Median arcuate ligament syndrome: A chronic mesenteric ischemia mimic, easily diagnosed with CTA
Abstract
Objectives
Our purpose is to present clinical symptoms and imaging findings of a scarce vascular syndrome mimicking chronic mesenteric ischemia, often in need for surgical treatment.
Background
Median arcuate ligament syndrome, also known as celiac artery compression syndrome, is a rare entity often misdiagnosed. Classic symptoms include postprandial abdominal pain, weight loss, nausea and vomiting. Due to its clinical presentation mimicking other conditions such as peptic ulcer, gallbladder disease, appendicitis and mesenteric ischemia, patients suffering from this disease usually undergo multiple radiological and gastroenterological examinations before they get their final diagnosis by Computed Tomography Angiography (CTA). We present 2 such patients who came to our Computed Tomography Department in order to investigate the aforementioned symptomatology by undergoing a CTA examination.
Imaging findings OR Procedure findings
In both patients there was absence of celiac artery atherosclerosis, whereas focal narrowing of the superior aspect of the proximal celiac trunk and post-stenotic dilatation existed (‘the classic hooking configuration of the proximal celiac trunk’). In one of the patients, proximal superior mesenteric artery compression coexisted. There also was thickening of the median arcuate ligament in both cases (5.7mm and 8mm respectively).
Conclusion
CTA is considered to be the gold-standard imaging examination for the detection of celiac artery compression syndrome. It easily presents the proximal celiac stenosis with classic hooking configuration, post-stenotic dilatation or collateral formation and thickness of the median arcuate ligament of more than 4 mm. Symptomatic patients should be surgically treated by dividing the median arcuate ligament, usually laparoscopically.
SE-021 - The role of CT guided percutaneous cholecystostomy for high risk surgical patients with acute cholecystitis and optimal timing of surgical cholecystectomy after the procedure: Α retrospective study in a single centre.
Abstract
Purpose
To determine and depict the benefits of temporary or permanent relief of symptoms after percutaneous cholecystostomy in high risk surgical patients with acute cholecystitis and also to determine the optimal timing of laparoscopic cholecystectomy after this procedure.
Material and methods
A retrospective study was conducted in 87 patients who underwent cholecystectomy after percutaneous cholecystostomy. The patients were divided into two groups by the operation timing. Group I patients underwent cholecystectomy within 10 days after percutaneous cholecystostomy (n=43) and group II patients underwent cholecystectomy at more than 10 days after percutaneous cholecystostomy (n=44).
Results
There was no significant difference between groups in conversion rate to open surgery, operation time, perioperative complications rate, and days of hospital stay after operation. Complications related to cholecystostomy such as catheter dislodgement occurred only in 5 patients, 2 from group I and 3 from group II. The 3 patients from group II developed symptoms such as fever and abdominal pain. (Group I 4,7% -Group II 6,8%)
Conclusion
CT guided percutaneous cholecystostomy is an alternative treatment to resolve acute inflammation in patients with severe comorbidities. Timing of laparoscopic cholecystectomy after percutaneous cholecystostomy did not influence postoperative outcomes.
Presenter of 2 Presentations
EE-002 - Median arcuate ligament syndrome: A chronic mesenteric ischemia mimic, easily diagnosed with CTA
Abstract
Objectives
Our purpose is to present clinical symptoms and imaging findings of a scarce vascular syndrome mimicking chronic mesenteric ischemia, often in need for surgical treatment.
Background
Median arcuate ligament syndrome, also known as celiac artery compression syndrome, is a rare entity often misdiagnosed. Classic symptoms include postprandial abdominal pain, weight loss, nausea and vomiting. Due to its clinical presentation mimicking other conditions such as peptic ulcer, gallbladder disease, appendicitis and mesenteric ischemia, patients suffering from this disease usually undergo multiple radiological and gastroenterological examinations before they get their final diagnosis by Computed Tomography Angiography (CTA). We present 2 such patients who came to our Computed Tomography Department in order to investigate the aforementioned symptomatology by undergoing a CTA examination.
Imaging findings OR Procedure findings
In both patients there was absence of celiac artery atherosclerosis, whereas focal narrowing of the superior aspect of the proximal celiac trunk and post-stenotic dilatation existed (‘the classic hooking configuration of the proximal celiac trunk’). In one of the patients, proximal superior mesenteric artery compression coexisted. There also was thickening of the median arcuate ligament in both cases (5.7mm and 8mm respectively).
Conclusion
CTA is considered to be the gold-standard imaging examination for the detection of celiac artery compression syndrome. It easily presents the proximal celiac stenosis with classic hooking configuration, post-stenotic dilatation or collateral formation and thickness of the median arcuate ligament of more than 4 mm. Symptomatic patients should be surgically treated by dividing the median arcuate ligament, usually laparoscopically.
SE-021 - The role of CT guided percutaneous cholecystostomy for high risk surgical patients with acute cholecystitis and optimal timing of surgical cholecystectomy after the procedure: Α retrospective study in a single centre.
Abstract
Purpose
To determine and depict the benefits of temporary or permanent relief of symptoms after percutaneous cholecystostomy in high risk surgical patients with acute cholecystitis and also to determine the optimal timing of laparoscopic cholecystectomy after this procedure.
Material and methods
A retrospective study was conducted in 87 patients who underwent cholecystectomy after percutaneous cholecystostomy. The patients were divided into two groups by the operation timing. Group I patients underwent cholecystectomy within 10 days after percutaneous cholecystostomy (n=43) and group II patients underwent cholecystectomy at more than 10 days after percutaneous cholecystostomy (n=44).
Results
There was no significant difference between groups in conversion rate to open surgery, operation time, perioperative complications rate, and days of hospital stay after operation. Complications related to cholecystostomy such as catheter dislodgement occurred only in 5 patients, 2 from group I and 3 from group II. The 3 patients from group II developed symptoms such as fever and abdominal pain. (Group I 4,7% -Group II 6,8%)
Conclusion
CT guided percutaneous cholecystostomy is an alternative treatment to resolve acute inflammation in patients with severe comorbidities. Timing of laparoscopic cholecystectomy after percutaneous cholecystostomy did not influence postoperative outcomes.