Surgical Treatment of Stent Occlusion in Celiac Artery; A Rare Case Report ‘Aorto-Hepatic Bypass’

Öz

Objective: Chronic mesenteric ischemia is a rare clinical condition characterized by loss of appetite, weight loss, and abdominal pain after meals. Although advanced age and atherosclerosis are the two most important risk factors, they can also accompany multi-systemic conditions. Various methods are available for the treatment of celiac, superior and inferior mesenteric artery stenosis causing mesenteric ischemia. These methods are; traditional surgery, endovascular approach and endarterectomy. In this study, it was planned to present a patient whose stent was occluded in the celiac artery and who subsequently underwent aorto-hepatic bypass. Case: A 62 year old male patient who was operated for a malignant gastric tumor 15 years ago and to whom stent was replaced to the celiac artery due to stenosis 2 years ago, admitted to the clinic for recurrency of abdominal pain. CT angiography was performed and stent obstruction was detected in the celiac artery. The abdomen was opened for the second time and a bypass operation was performed with the saphenous vein between the infrarenal aorta and the hepatic artery. Conclusion: Chronic mesenteric ischemia is a pathology that should be considered in the etiology of abdominal pain, and open surgery is a viable method in the treatment of arterial occlusions that may cause the disease in question, in cases where endovascular method is not suitable or a secondary intervention is required after endovascular procedure is performed beforehand

Anahtar Kelimeler

• Chronic mesenter ischemia
• Celiac artery
• Stent
• Bypass

Çölyak Arter Stent Oklüzyonunun Cerrahi Tedavisi; Nadir Bir Olgu Sunumu ‘Aorto-Hepatik Baypas’

Öz

Amaç: Kronik mezenter iskemi; iştahsızlık, kilo kaybı, yemeklerden sonra meydana gelen karın ağrısı ile seyreden, nadir bir klinik durumdur. İleri yaş ve ateroskleroz en önemli iki risk faktörü olmakla birlikte multi-sistemik durumlara da eşlik edebilir.Mezenter iskemiye neden olan çölyak, superior ve inferior mezenter arter stenozunun tedavisinde çeşitli yöntemler mevcuttur. Bu yöntemler; geleneksel cerrahi, endovasküler yaklaşım ve endarterektomi olarak sayılabilir. Bu çalışmada çölyak arterindeki stenti tıkanan ve sonrasında aorto-hepatik baypas yapılan hastanın sunulması planlandı. Olgu: Malign mide tümörü nedeni ile 15 yıl önce opere edilen ve 2 yıl önce de çölyak arter stenozu tespit edilip stent yerleştirilen 62 yaşındaki erkek hastada karın ağrısı şikayetlerinin tekrarlaması üzerine yapılan CT anjiografide çölyak arterdeki stentte tıkanıklık tespit edildi.ikinci kez batın açılarak infrarenal aorta ile hepatik arter arasına safen ven ile baypas operasyonu yapıldı. Sonuç: Kronik mezenter iskemi, karın ağrısı etiyolojisinde düşünülmesi gereken bir patoloji olup söz konusu hastalığa neden olabilecek arteriyel tıkanıklıkların tedavisinde endovasküler yönteme uygun olmayan veya öncesinde endovasküler işlem yapılıp ikincil bir girişim gereken durumlarda açık cerrahi yöntem uygulanabilir bir metoddur

Anahtar Kelimeler

• Kronik mezenter iskemi
• Çölyak arter
• Stent
• Baypas

Kaynakça

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