Overview
Celiac crisis refers to severe ischemic complications often due to celiac artery stenosis or occlusion, though clinically significant ischemic bowel disease is rare due to collateral circulation from the superior mesenteric artery. 1Diagnosis
Abdominal bruits, particularly in the epigastrium, may indicate celiac artery stenosis, often of extrinsic compression type 2.
Abdominal angiography can confirm stenosis or occlusion of the celiac artery and identify collateral circulation patterns 2.Management
Interventional radiology (IR) techniques are primary, including dilation of pancreaticoduodenal arcades for collateral vessel augmentation 1.
Transcatheter arterial chemoembolization and coil embolization may be adjunctive in specific cases involving complications like aneurysms 1.Special Populations
No specific guidance provided for pregnancy, pediatrics, elderly, or comorbidities in the given abstracts [].Key Recommendations
Utilize abdominal angiography to diagnose celiac artery stenosis or occlusion and assess collateral circulation patterns (Evidence: Moderate 2).
Employ interventional radiology techniques, such as dilation of pancreaticoduodenal arcades, for managing celiac artery stenosis (Evidence: Weak 1).
Consider transcatheter arterial chemoembolization or coil embolization for complications like aneurysms, though evidence is limited (Evidence: Weak 1).References
1 Ikeda O, Tamura Y, Nakasone Y, Yamashita Y. Celiac artery stenosis/occlusion treated by interventional radiology. European journal of radiology 2009. link
2 McLoughlin MJ, Colapinto RJ, Hobbs BB. Abdominal bruits. Clinical and angiographic correlation. JAMA 1975. link