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


BACKGROUND
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.


CONCLUSIONS
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.
Daniels
Alan H
AH
School of Medicine, Oregon Health and Science University, Portland OR, USA.
Jurgensmeier
Darin
D
McKee
Jason
J
Harrison
Marvin W
MW
d'Amato
Charles R
CR
D000208:Acute Disease; D000293:Adolescent; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D003251:Constriction, Pathologic; D013505:Digestive System Surgical Procedures; D005704:Gallbladder / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008099:Liver / Q000098:blood supply; D008297:Male; D009336:Necrosis; D011859:Radiography; D012544:Scheuermann Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*; D013154:Spleen / Q000098:blood supply; D013270:Stomach / Q000098:blood supply; D016896:Treatment Outcome