Celiac Artery Compression Syndrome in an Adolescent Male

TL;DR

A 16-year-old male with unexplained weight loss and an abdominal bruit was diagnosed with celiac artery compression syndrome, a rare condition in adolescents.

Contribution

This case highlights celiac artery compression syndrome in a rare pediatric context with atypical presentation and weight loss.

Findings

The patient's abdominal bruit and imaging findings confirmed celiac artery compression syndrome.

The patient's significant weight loss and lymphadenopathy prompted extensive diagnostic testing.

The case emphasizes the importance of considering rare vascular anomalies in adolescents with unexplained symptoms.

Abstract

Celiac artery compression syndrome is not frequent in the pediatric population. The syndrome may entail long-standing abdominal pain, recurrent vomiting, bloating, weight loss, and an abdominal bruit, which in the case of our patient, was an incidental finding. Notably, patients may be asymptomatic.

Our patient is a 16-year-old male who presented with concerns about multiple, non-tender chest lymph nodes lasting for two weeks. He had also lost 80 lbs. over one year. On examination, however, an abdominal bruit was discovered, and a diagnostic workup was significant for celiac artery compression following a magnetic resonance angiography of the abdomen. Due to his significant weight loss and mediastinal lymphadenopathy, a chest computed tomography (CT) scan was done to rule out malignancy. The chest CT scan was reported as normal. Additionally, a renal duplex ultrasound was done to rule out renal artery stenosis, considering he had presented with elevated blood pressure; this was also unremarkable.

Although this patient had a history of marijuana use, his assessment did not show marked dependence. Substance abuse and atherosclerotic vascular disease can be predisposing factors for celiac artery compression syndrome in older individuals. However, compression of the celiac trunk by the median arcuate ligament is a congenital anomaly more appreciated in younger age groups. The patient was referred to vascular surgery for possible median arcuate ligament release.

Figures