Coeliac Artery Thrombosis – An acute Occlusive Disease

Coeliac Artery Thrombosis – An acute Occlusive Disease

Coeliac Artery Thrombosis is a rare acute clinical condition. The prevalence of this disease is only %5. This disease or acute condition have a high mortality rate over than %60. For this reason, it is necessary to diagnose immediately and should start to treatment urgently. The treatment goal is to restoring blood circulation immediately of the affected tissues. This treatment involves surgical resection of affected-necrosed tissue if necessary and close monitoring in intensive care unit. Some patients can treated only with antithrombotic drugs also without surgical procedure.

Coeliac Artery Thrombosis and Coeliac Trunk Branches:

Celiac trunk main branches:

  • Left gastric artery (Arteria gastrica sinistra)
  • Gastroduodenal artery (Arteria gastroduodenalis)
  • Splenic artery (Arteria splenica)
  • Hepatic artery (Arteria hepatica)

These arteries are the main branches of coeliac artery.

Left gastric artery (Arteria gastrica sinistra) branches:

Turns around the small curvature of stomach and has not any branches.

Gastroduodenal artery (Arteria gastroduodenalis) branches:

  • Right gastroepiploic artery (Arteria gastroepiploica dextra)
  • Superior pancreaticoduodenal artery (Arteria pancreaticoduodenalis superior)

Splenic Artery (Arteria splenica) branches:

  • Dorsal splenic artery and Splenic arterioles
  • Short gastric artery
  • Left gastroepiploic artery (Arteria gastrica sinistra)

Hepatic artery (Arteria hepatica) branches:

  • Cystic artery (Arteria cystica)
  • Right gastric artery (Arteria gastrica dextra)
  • Gastroduodenal artery (Arteria gastroduodenalis)
  • Right hepatic artery (Arteria hepatica dextra)
  • Left hepatic artery (Arteria hepatica sinistra)

Known this branches of celiac artery is important for celiac artery thrombosis also. Because, the symptoms are related from blood flow defects of these arteries. As it is understood from this, delaying in correct diagnosis will lead to impaired perfusion and necrosis in organs such as the stomach, liver, pancreas and spleen.

Coeliac Artery Thrombosis risk factors:

The most causative risk factors to Coeliac artery thrombosis are advanced age, atherosclerosis, connective tissue diseases, coagulation disorders, pancreatitis, surgical trauma and the other congenital anomalies also. For this reasons, the patients usually apply to the hospital before this clinical picture due to atherosclerosis, coronary, cerebrovascular, peripheral arterial insufficiency. With it, excessive fatty diet, sedentary lifestyle and smoking are other environmental risk factors also.

Coeliac Artery Thrombosis symptoms and treatment:

Sudden onset pain in the abdomen may develop. Then, the pain will gradually increases within in a few hours. However, it will feeled generally around the whole abdomen. Sometimes nausea and vomiting may seen in this patients. In addition, fever and diarrhea have also reported. Bloody stools is not rare also. If the arterial flowing does not achieved, the patient will rapidly gone worse and will need intensive care. Then after, the patient will die in a few days. For this reason emergency diagnosing and treatment is life saver. In some patients with anticoagulant therapy; especially warfarin, aspirin and with heparin treatment the thrombosis can be solved and treated. However, if thrombosis-related necrosis develops, the operation should planned immediately and necrotic segments must removed.

Angiography and computed tomography will give information about the course of the disease. With it, if the markers of ischemia, such as D-dimer or lactate are elevated, the surgical procedure should be planned immediatly.

 

To read about Plummer Vinson syndrome click this link

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