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.
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: Carmen Turowski; Michelle R Downes; Deirdre M Devaney; Veronica Donoghue; John Gillick Journal: Pediatr Surg Int Date: 2010-06-08 Impact factor: 1.827
Authors: Sarah Gander; Daniel J Mulder; Sarah Jones; John D Ricketts; Don A Soboleski; Christopher J Justinich Journal: Can J Gastroenterol Date: 2010-02 Impact factor: 3.522