%0 Journal Article
%T Surgical treatment of Dunbar syndrome Tratamento cir¨²rgico da s¨ªndrome de Dunbar
%A Lu¨ªs Henrique Gil Fran£¿a
%A Carla Mottin
%J Jornal Vascular Brasileiro
%D 2013
%I Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
%X Dunbar syndrome or celiac artery compression syndrome is an infrequently described clinical condition with poorly defined diagnostic criteria and an obscure pathophysiology. It is usually associated with an extrinsic compression upon the celiac axis near its takeoff from the aorta by fibrous diaphragmatic bands or sympathetic neural fibers. The authors report the case of a 70-year-old male patient presenting with nausea, epigastric pain, and weight loss. An aortography showed a compression of the celiac trunk. A preliminary attempt at percutaneous transluminal angioplasty and stenting proved unsuccessful. The patient became asymptomatic and his clinical condition improved after surgical release of the celiac trunk by partial section of the arcuate ligament of the diaphragm and with resection of the neural, fibrotic, and lymphatic tissues surrounding the aortic and visceral vessels. The purpose of this report is to discuss the indications and the therapeutic options of this syndrome. A s¨ªndrome de Dunbar ou compress o do tronco cel¨ªaco ¨¦ uma condi  o cl¨ªnica infrequente, com poucos crit¨¦rios para diagn¨®stico e com patofisiologia obscura. Est¨¢ usualmente associada ¨¤ compress o extr¨ªnseca do tronco cel¨ªaco por banda fibrosas do diafragma e fibras neurais simp¨¢ticas, pr¨®ximo a sua emerg¨ºncia da aorta. Os autores relatam um caso de um paciente de 70 anos de idade com quadro de n¨¢useas, dor epig¨¢strica e perda de peso. Uma arteriografia mostrou compress o do tronco cel¨ªaco. Uma primeira tentativa de angioplastia com stent foi realizada em outro servi o, mas sem sucesso. Ap¨®s o tratamento cir¨²rgico que consistiu de sec  o parcial do ligamento arqueado do diafragma com ressec  o dos tecidos fibr¨®ticos, neurais e linf¨¢ticos que circundavam a aorta e as art¨¦rias viscerais, o paciente obteve melhora cl¨ªnica e tornou-se assintom¨¢tico. O objetivo deste estudo ¨¦ discutir as indica  es e op  es terap¨ºuticas desta s¨ªndrome.
%K arteriopatias oclusivas
%K isquemia
%K art¨¦ria cel¨ªaca
%K arterial occlusive diseases
%K ischemia
%K celiac artery
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492013000100012