Why you should know about celiac artery compression syndrome

Do you experience pain in your stomach after you eat? Have you been experiencing weight loss?

Illustration by Scott Holmes, CMI, Michael E. DeBakey Department of Surgery

If the pain occurs regularly and has been going on for several months, it might be a symptom of celiac artery compression syndrome.

Dr. Charles A. West, associate professor in the Michael E. DeBakey Department of Surgery and an expert in celiac artery compression syndrome, explains the rare syndrome and what you need to know about it.

Q: What is celiac artery compression syndrome?

A: Celiac artery compression syndrome, also known as median arcuate ligament syndrome, is a condition where a muscular fibrous band of the diaphragm, called the median arcuate ligament, compresses the celiac artery, which supplies blood to the upper abdominal organs.

Q: What are the symptoms?

A: The main symptoms are chronic abdominal pain that has lasted for several months; often times the pain may occur immediately after meals. Other symptoms may include weight loss, and sometimes an abdominal bruit, or the sound made by blood flowing through an obstruction.

Q: Why should people be aware of this syndrome?

Dr. Charles A. West, associate professor in the Michael E. DeBakey Department of Surgery

A: It could be the cause of persistent abdominal pain that has not been treated successfully. This condition is generally not life threatening, but it is debilitating.

Q: How can it be diagnosed?

A: The doctor will get familiar with the patient’s clinical history, and will do a physical exam followed by an imaging study of the visceral and intestinal arteries.

Often the first imaging test is a duplex ultrasound, which may be followed by a computed tomography (CT) angiogram or a conventional angiogram.

Q: How is it treated?

A: Surgery is the recommended treatment. This can be performed from an incision in the upper abdomen, which allows the doctor to surgically release the constraining ligament.

In some cases, the procedure can also be performed laparoscopically; releasing the constraining ligament using a thin tube, the laparoscope, inserted through a small incision in the abdomen.  Sometimes, a bypass procedure is required to restore the blood supply to the affected area.

Q: Does the treatment cure the disease?

A: Some people respond better than others. The patients who have significant abdominal pain after eating and have lost significant weight from the condition usually have a better response to surgical treatment than patients who have less pain and weight loss. Women younger than 60 years also tend to respond better than older patients.

If you have had abdominal pain for months, especially after eating, and have not treated it successfully, consider consulting with a vascular surgeon about the possibility that celiac compression syndrome might be the cause of your problem.

For more questions about celiac artery compression syndrome or to schedule a consultation with Dr. West, call 713-798-5700 or email cw5@bcm.edu.

-By Ana Maria Rodriguez, Sr. Medical Editor, Michael E. DeBakey Department of Surgery

27 thoughts on “Why you should know about celiac artery compression syndrome

  • July 26, 2015 at 9:47 am
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    I have been suffering with abdominal pain & severe epigastric pain into the right breast & back for about 3 years & becoming increasingly worse, surgery is going to be done to release the ligament around the celiac artery next month. Is there anyone one that I can talk to that I can talk to that has had this syndrome, & procedure. The pain has really increased, & want to make sure this is what the problem is.

    Reply
  • October 9, 2015 at 3:59 pm
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    I was just told that I have this as well. I have had this pain for years and finally found a doctor that did the right test to find it. By any chance have you had the surgery yet and if so did it make you feel better. Thank you so much..Lorene

    Reply
    • June 17, 2016 at 2:12 pm
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      I have had a balloon put in my celiac artery in 2014 , then a stent in 2015 . Now just had another ct scan and said it was 50% blocked again . Going to an other Doctor to see what can be done , and why this keeps coming back.

      Reply
      • June 27, 2016 at 12:17 pm
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        Yes I had the surgery 6 weeks ago by Dr West a Baylor in Houston. Many tests were done to see if I truly had celiac compression stenosis, which I did and if I was a good candidate for the corrective surgery and I was. The ligament was fully cut from around the artery and the the blood came happily gushing out and instantly the next day I new it was successful. I have the balloon is not used cor celiac artery compression stenosis. So if that is what you truly have you were treated incorrectly. Dr. West specializes in this type of surgery and is extremely careful to make sure that you are a good candidate for the surgery. Hope this helps.

        Reply
  • November 21, 2015 at 10:51 am
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    I have been diagnosed with celiac artery stenosis
    Which is greater than 96% What is the surgical
    Procedure for a this? I’m 65 my mother died from a SMA infarct. I’ve suffered with ischemic colitis for years, including two bowel resections I went to see
    a cardiologist, was diagnosed by CTA. I am frightened. I worked in OR OHS, Vascular etc 39yrs I know what complications occur. ASAP
    Thank you
    Kathy Mith

    Reply
    • November 24, 2015 at 5:38 pm
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      Hi Kathy, thanks for reading Momentum. Dr. West’s contact information is cw5@bcm.edu or 713.798.5700. Best, -Audrey

      Reply
  • November 28, 2015 at 4:15 pm
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    Does this need intervention? My aorta, lilacs, femoral , SMA IMA are widely patent. The celiac artery. Is the. Only place of stenosis. I’m 65 Heart
    valves, coronary arteries are patent. I.also have collaterals showing on the CTA, I live in Last Vegas have not had a definitive explanation, does a vascular surgeon or radiologist do intervention? Cardiothoracic surgeons do not fix this unless it’s a ruptured AAA then the artery is obligated. If I have no atherosclerotic areas, should I be ok.
    Thank you
    Keep. Smith

    Reply
  • January 2, 2016 at 8:10 pm
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    I was healthy as humanly possible and had 4 Lipomas removed on October 7th. One on the bend of my arm and 3 on my 3 level lumbar hardware; 3 were the size of an egg and 1 the size of baseball – softball, all normal. I was fine 2 days and on the third day I had Atalexisis of my right lung. A week later the Left Lower Lobe collapsed. I’ve been to the ER 5 times in 7 weeks. My last CT was ordered by PulmonarySpecialist. I have IPF and never smoked a day in my life nor ever been around second hand smoking. The resultsof Two CT and ultra sound, is “High Grade Stenosis of Celiac Artery”. I have not responded to any of breathing treatments at home and I have no energy and I collapse when I get home? I am slightly anemic. I know I’m not well and need a third opinion. I have seen two different specialists at two different hospitals in the area I live by Vascular Surgeons. I would appreciate any recommendations of who Is a specialist in this field that would consider seeing me. I have very good insurance coverage BCBS with MASA. My husband is retired from Emergency Medicine 27 years. He now is a Chronic Pain Specialist. It is not ethical for him to treat me as a patient. Thank you for your assistance.

    Reply
  • January 3, 2016 at 11:23 pm
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    Hi There, I am a 57 year old female and I have recently been through 3 CTs of my lungs and 1 ultrasound of kidneys. I had complications from removing 4 Lipomas on my lumbar (3), one of the bend of my left arm on Oct.07, 2015. Three days later, I developed Atalectasis in my right lung, a week later my left lung developed Left Lower Lobe Collapsed. Throughout this time my health spiraled. I have been to the ER 5 times. Two of my CTs indicated High Grade Stenosis of Celiac Artery. I have pretty much been healthy most of my life. I have never smoked, nor been around second hand smoke due to my allergies. My Blood Pressure has escalated and been uncontrollable. I really would like to know if I could fly out to your facility for a consultation and/or evaluation and treatment. My spouse has since medically retired 27 years in Emergency Medicine and now practices in Pain Management. He is very supportive in finding me a Top Surgeon in this field, in which by reading Baylor has an excellent reputation in this specialty. I live in Southeast Alabama and willing to fly to Houston. Thank you for your reply.

    Reply
    • March 10, 2016 at 4:47 pm
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      You might also check out a support group on Facebook: MALS Pals. Over 400 MALS sufferers there from all over.

      Reply
  • February 9, 2016 at 3:48 am
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    Hi, I would like know where a can do the cirurgy laparoscopy, because I interested, thanks,

    Reply
  • March 28, 2016 at 4:29 pm
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    I was diagnosed with celiac Compression stenosis greater than 70% recently and apparently this goes back at least 4 yrs w/o my knowledge. I cannot eat w/o pain and have experienced weight loss. I now live in NM and there seems to be a lack of knowledge on how to deal with this issue. I was a patient of Dr
    Frank Meriano when I lived in Houston and would like to return to Houston and the Baylor school of Medicine for more tests and possible treatment as NM is quite lacking in many areas of medical expertise and is now using “visiting Dr’s” and I rarely see the same Dr on a regular basis….

    Reply
  • July 17, 2016 at 7:13 pm
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    I have had stomach pain for 25 months!
    Taken every test there is from colonoscopy to ultra sounds to MRA toMRi to cat scan! Nothing showed up!
    Except a small artery leading to intestines was blocked! Had a stint put in! Then my gall bladder had some inflammation , had it removed! No results! Had two plexus blocks I down my throat another conventional through my spine! Going to have another one performed 7/20/16! In pain most of day!
    Pain subsides at 9pm almost every night! Get about 6 hrs sleep wake up in pain most mornings! Pain doesn’t increase after eating!

    Reply
  • January 13, 2018 at 6:08 am
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    After a lifetime of suffering with fatigue and stomach pain I have finally been diagnosed with MALS. Due to nausea I was unable to drink the contrast before my last CT scan. I can’t help but feel that this allowed the celiac compression to be viewed on the scan as it was never seen in previous scans. I finally feel vindicated after being told there was nothing wrong with me or being miss diagnosed more times than I can remember. Now all I have to do is find the right doctor for this procedure.

    Reply
  • February 19, 2018 at 11:32 am
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    Hi,
    I was just diagnosed with CAC after experiencing abdominal pain and nausea after eating. I wonder if anyone has figured out whether exercising increases the pain. After a yoga class where I did some twisting and light abdominal exercises i felt abdominal pain and felt like the food I injested after the group just sat there. The sensation of fullness remained all day and even a little tea seemed to add to that discomfort.

    Reply
  • July 4, 2018 at 12:06 pm
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    For 2 years i have had severe stomach pains especially after eating and my stomach makes the WEIRDEST sounds for hours. The pain is EXTREMELY severe and the noises are so odd and loud that you can hear them from across a crowded room!! I was diagnosed with Chrohns disease and was told i had scar tissue in small bowel causing a narrowing that keeps me constipated. I have lost over 80 pounds since this started. Now the pain in my upper abdomen is so severe I am afraid to eat because it hurts my stomach and back. The noises are now louder and longer. Yesterday’s CT scan showed severe stenosis of celiac artery but I was just told that this is not an emergency by the hospitalist at the hospital i am currently admitted to. I also have severe psoriasis and have plaque all over abdomen causing EVERY surgeon to turn me away because I am considered high risk when it comes time to heal. My life is beyond miserable. No one should have to live with this pain and suffering. I actually told my Dr I would rather not live than to live like this. What should I do? I cannot get any Dr to take my case because im labeled “high risk” because of my psoriasis.

    Reply
  • October 1, 2018 at 5:19 pm
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    I have an itchy rash on my abdomen (and on my upper back) since early July of 2018 ….had blood tests and two biopsies–one on my abdomen and one on my inner arm— to look for Celiac disease, but they weren’t conclusive and two dermatologists couldn’t figure it out….it has been about 3 + months since I have this…I hate to have an endoscopy to figure it all out…but could it be Celiac Stenosis or something else???

    Reply
    • October 15, 2018 at 8:20 am
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      Hi Joyce,

      Thanks for reading the Momentum blog. To schedule an appointment with our Vascular Surgery and Endovascular Therapy Care Center, please call 713-798-5700 or find more information online.

      -Nicole

      Reply
  • December 4, 2018 at 7:24 am
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    I must start with , that I am for the first time in over 20 YEARS Hopeful, After reading these stories ..I now know that I am not crazy. Most of the stories could have been written by me. The dull, or sharp agonizing , lingering 24/7 pain is killing my spirit. I can’t go over my history one more time with another new primary care Doc, I always end up crying, feeling insane. My Mother is at her wits end as well . We have nicked-name my pain as my “THING”..all my friends and co-workers are just used to me in the “Napoleon pose”
    I am 54 years old, Mornings are the worst for me as well, while the pain level maybe going down to about 6 by ten p.m. My Husband and I used to do a lot of things, Know I imagine my pain tagging along with us, and I just cant do it. I don’t mean to sound mean ..but I wish I could make everyone I know,
    ( Including ALL of my past Dr’s ) just “Feel” it for 24 hours….then they all would come to me and say
    ” ARE YOU SERIOUS ! ” I just cant bear this any longer. I go to bed at night, KNOWING that I am going to wake up in worse pain then I am already in, my Husband dreads waking me up in the morning, I stomp and swear to myself when I’m in the shower. I look at other people, wishing i was them. I can still laugh , work and socialize.. but all the while my pain is mocking me. Eating is becoming a chore, and that’s just not fair, I have gotten to the point where I am afraid to eat and at 5’4 and now down to 110 pounds from 117 , I can’t afford to loose my love for food..I am just so done..I have always told my Mom..that I would know right away ( without anyone telling me ) after waking up from surgery if they “GOT IT “..I will be contacting Dr. West. Fingers crossed for me and everyone above .

    Reply
    • January 24, 2019 at 7:44 pm
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      😭😭😭same here all that u said

      Reply

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