Acute celiac artery compression syndrome after surgical correction of Scheuermann kyphosis.

Abstract

STUDY DESIGN:

A case of acute celiac artery compression syndrome after spinal fusion in a patient with Scheuermann kyphosis is reported.

OBJECTIVE:

To describe the unusual complication of acute celiac artery compression after surgical kyphosis correction, to outline diagnostic methods, and to review the pertinent literature.

SUMMARY OF BACKGROUND DATA:

Chronic celiac artery compression syndrome is well described, yet there is only 1 reported case of acute celiac artery compression after surgical correction of kyphosis. There have been no previous reports of this complication leading to foregut ischemic necrosis after correction of Scheuermann kyphosis.

METHODS:

Case report and literature review.

RESULTS:

After an anterior release and posterior spinal fusion for a 106 degrees kyphotic deformity performed under 1 anesthetic, our patient developed a perforated gastric antrum on postoperative day 5, evolving to ischemic necrosis of the stomach, gallbladder, and spleen discovered on postoperative day 7. Abdominal angiography indicated that his celiac artery had been occluded at its origin. After this event, the patient required a prolonged intensive care hospital stay and required a Roux-en-Y gastro-jejeunostomy reconstruction. He is now doing well at 1-year follow-up with independent ambulation and a regular diet.

CONCLUSION:

Acute celiac artery compression after surgical kyphosis correction is a rare but potentially serious adverse event. Spinal deformity surgeons and intensivists should be aware of this entity, and should have a high index of suspicion for it if sepsis of unknown origin, an acute abdomen, or elevated liver enzymes are encountered after surgery after correction of a kyphotic deformity.

• Authors: Alan H Daniels, Darin Jurgensmeier, Jason McKee, Marvin W Harrison, Charles R d'Amato
• Journal: Spine (Spine (Phila Pa 1976)) Vol. 34 Issue 4 Pg. E149-52 (Feb 15 2009) ISSN: 1528-1159 [Electronic] United States
• PMID: 19214085 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Acute Disease
• Adolescent
• Arterial Occlusive Diseases (diagnostic imaging, etiology, surgery)
• Celiac Artery (diagnostic imaging, surgery)
• Constriction, Pathologic
• Digestive System Surgical Procedures
• Gallbladder (blood supply)
• Humans
• Ischemia (diagnostic imaging, etiology, surgery)
• Liver (blood supply)
• Male
• Necrosis
• Radiography
• Scheuermann Disease (diagnostic imaging, surgery)
• Spinal Fusion (adverse effects)
• Spleen (blood supply)
• Stomach (blood supply)
• Treatment Outcome