• Korean Journal of Radiology
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• v.2 no.1
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• pp.8-13
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• 2001

Objective: To determine the incidence and etiologies of celiac axis stenosis in asymptomatic individuals. Materials and Methods: This prospective study involved 400 consecutive patients (male: 319, female: 81) referred to us for celiac arteriography between April and July 1999. When celiac axis branches were opacified by collateral circulation during superior mesenteric arteriography, the presence of celiac axis stenosis was suspected; lateral projection celiac arteriography was performed and the pressure gradient was measured. The indicators used to determine whether or not celiac axis stenosis was significant were luminal narrowing of more than 50% and a resultant pressure gradient of at least 10 mmHg. Its etiology was determined on the basis of angiographic appearances and CT findings. Results: Twenty-nine patients (7.3%) had celiac axis stenosis. The etiology of the condition was extrinsic compression due to the median arcuate ligament in 16 patients (55%) and atherosclerosis in three (10%), while in ten (35%) it was not determined. The incidence of celiac axis stenosis did not vary significantly according to sex, age and the presence of calcified aortic plaque representing atherosclerosis. Conclusion: The incidence of hemodynamically significant celiac axis stenosis in this asymptomatic Korean population was 7.3% and the most important etiology was extrinsic compression by the median arcuate ligament of the diaphragm. Atherosclerosis was only a minor cause of the condition.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.325-329
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• 1989

A rare case of aneurysm of the celiac artery due to arteriosclerosis was presented. The patient was 56-year-old female and had suffered from hypertension for 4 years, and recently, from dyspepsia prior to admission for 2 months. The operation was operated upon by interposition of an autogenous tubular saphenous vein graft between the proximal celiac artery and the common opening of the hepatic and the splenic arteries in the opened aneurysmal sac with inclusion technique. The postoperative course was uneventful.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.276-279
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• 2023

The arterial support of the liver is most commonly from the celiac trunk via the proper hepatic artery (PHA). The PHA divides into left and right branches: the right hepatic artery (RHA) supplies the right and caudate lobes while the left hepatic artery (LHA) supplies the left and quadrate lobes. Aberrant hepatic arteries are relatively common, and the most frequent contributors are the superior mesenteric artery and left gastric artery. Herein we present findings from postmortem dissection of an abdominal cavity that revealed a rare combination of reported variations. Specifically, this subject had three extrahepatic arteries - a replaced LHA (rLHA), a PHA, and a replaced RHA (rRHA). The rLHA originated from the left gastric and the rRHA originated from the superior mesenteric artery. Knowledge of these variations is important for surgical and radiological procedures to avoid complications during treatment and improve patient outcomes.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.87-94
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• 1999

Backgroud: We have performed the CT-guided celiac plexus block (CPB) using anterior approach to evaluate the safety and efficacy of the procedure and to determine the role of CT. Methods: CPB were done in 10 patients (5 men and 5 women: mean age, 58.1 years) with intractable upper abdominal pain due to terminal malignancy of the stomach (n=3), pancreas (n=4), gallbladder (n=2), and liver (n=1). To permit an anterior approach, patients lay supine on the CT scan table during the procedure. One 21-guage Chiba needle was placed just anterior to the diaphragmatic crus between the celiac and superior mesenteric arteries and 10~12 ml of dehydrated alcohol was injected. Degree of pain relief following the procedure was assessed and pain was graded on a numeric rating scale (NRS) from 0 to 10. Results: The results suggest a direct relation between the degree of celiac invasion and the response to the CPB. With CT guidance, it is possible for us to direct the needle into more accurate region, allowing alcohol to be deposited in specific ganglion area. Conclusions: CT-guided CPB using an anterior approach was an easy and effective way of reducing intractable upper abdominal pain due to terminal malignancies. CT-guidance allowed precise needle placement and safe procedure. Careful classification of cases is important to predict the degree of pain relief using the grading system based on the degree of involvement of the celiac plexus.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.146-149
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• 2013

Mesenteric ischemic symptoms appear only when two of the three major splanchnic arteries from the abdominal aorta are involved. Recently, we encountered a case of chronic mesenteric ischemia in a 50-year-old female patient caused by atherosclerotic obstruction of the celiac trunk and superior mesenteric artery. She was treated with a retrograde bypass graft from the right common iliac artery to the superior mesenteric artery (SMA) in a C-loop configuration. Complete revascularization is recommended for treatment of intestinal ischemia. When the celiac trunk is a not suitable recipient vessel, bypass grafting to the SMA alone appears to be both an effective and durable procedure for treating intestinal ischemia.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.20-26
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• 2002

Background: Due to the concern of flow competition or retrograde steal, it has been generally suggested that the right gastroepiploic artery(RGEA) pedicled graft should be used in critical coronary stenosis lesion. The study was designed to evaluate the potential of retrograde flow competition in the RGEA pedicled graft by measuring the native pressure differences(PD) between the normal coronary artery and celiac arterial pressure, which would be compared with trans-stenosis pressure gradients(TSPG) in coronary artery occlusive disease. Material and Method: Between July, 1998 and February, 1999, pressures of the right coronary artery and the right gastroepiploic artery(or the celiac artery) were measured in patients with the patent right coronary artery(n=12). The PD between the arteries was compared with the TSPG in the occlusive coronary arteries(n=32). Result: The pressures of the normal right coronary artery and celiac artery were 143$\pm$23 vs. 134$\pm$17mmHg in systole(p<0.005), 74$\pm$13 vs. 73$\pm$14mmHg in diastole(p=NS), and 100$\pm$16 vs. 97$\pm$15mmHg in mean (p<0.05). The PD between the arteries were -8~25mmHg in systole, -4~7mmHg in diastole, and -1~10mmHg in mean. The TSPG measured in the occlusive coronary arteries were -4~19(7$\pm$5.8)mmHg in the lesion less than 75% stenosis vs. 7~74(27$\pm$18.3)mmHg in the 75% or over stenosis lesion(p<0.005). The normally existing pressure difference between the coronary arteries and RGEA(15~20mmHg) was significantlyless than the TSPG in .the occlusive coronary artery with 75% or over stenosis(p<0.001). Conclusion: If the pressure gradient between the RGEA and the coronary artery distal to the stenosis is the main determinant of development of retrograde flow competiton in the RGEA pedicled graft, the above data suggests that there will be little chance of competition when It is used in the coronary lesion with 75% or over stenosis.

• Journal of Chest Surgery
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• v.24 no.12
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• pp.1209-1213
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• 1991

We have experienced a case of upper abdominal aortic aneurysm in 51 years old man who entered to our hospital with abdominal and lower back pain for three days. The diagnosis was confirmed by abdominal ultrasonography and abdominal aortogram and he was treated by aneurysmectomy, bypass graft and endarterectomy. A brief review of related literature was made.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.93-96
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• 2005

Neurofibromatosis type I is an autosomal dominant disorder with varied manifestations in bone, soft tissue, the nervous system and skin. This is characterized by cafe-au-lait spots, neurofibromas, Lisch nodules, optic glioma, bony displasia, and intertriginous freckling. One of the more serious aspect of the disease relates to the arterial involvement. Vascular changes in neurofibromatosis may occur in any arterial tree from the proximal aorta to the small arteries but these changes are most common in the renal arteries, aorta, celiac arteries and mesenteric arteries. Of the many complications observed in neurofibromatosis type I, cerebrovascular lesions may be the least appreciated. About 40 cases of neurofibromatosis type I associated with occlusive cerebrovascular disorders have been reported in the literature, but MRI and angiographic findings typical of moyamoya disease are rarely described. We experienced a case of moyamoya disease associated with neurofibromatosis type I in a 3-year-old girl who of complained gait disturbance and paraparesis and showed findings typical of moyamoya disease on MRI and carotid angiogram.

• Journal of Chest Surgery
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• v.16 no.3
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• pp.301-309
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• 1983

Twenty-three patients with aneurysm were operated between Jan. 1956 to July 1983 at the Department of Thoracic surgery, Seoul National University Hospital. There were 18 males and 5 females in this series. The age ranged from 14 to 68 years with the mean age of 41 years. The etiology of aortic aneurysms was atherosclerosis in 10, trauma in 2, annuloaortic ectasia in 4, syphilis in 1, and unknown etiology in six cases. Among the 4 patients with ascending aortic aneurysm, aortic valve replacement with aneurysmorrhaphy in three patients and Bentall operation in one patient were performed successfully. One patient with entire aortic arch aneurysm was received Dacron graft replacement with anastomosis of brachiocephalic arteries separately under cardiopulmonary bypass. There was no complication. Among 6 patients involving the descending thoracic aorta, three patients were managed by prosthetic bypass graft and aneurysm resection, and another three patients were also managed by prosthetic graft replacement. There were three hospital deaths. There were two thoracoabdominal aortic aneurysm. One patient in shock state due to preoperative rupture died from cardiac arrest during operative procedure. In another patient who had extensive involvement from the midportion of descending thoracic aorta to the terminal abdominal aorta, the aneurysm was successfully repaired with Dacron graft. In this instance celiac axis, superior and inferior mesenteric arteries and right renal artery were anastomosed separately. Eight of the 10 abdominal aortic aneurysms was replaced with prosthetic graft. One saccular aneurysm was treated by resection and primary closure. In another patient, cardiac arrest occurred during operation before definitive procedure. There was one another hospital death in the patient with preoperative rupture.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.625-630
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• 1997

A 56 years old male patient adklitted to our neurology department because of repeated tingling sensation in right 3, 4, 5th. (infers and weakness on grasping, which were progressively developed re ently. At this time, he had also suffered from claudication in both lower extremities. Carotid angiogram showed that right internal carotid artery was obstructed completely, and both common, both external and left internal carotid arteries had significant stenosis, Concommitantly, aortogram suggested complete obstruction just below the renal arteries. We plamled staged operation for two separated arterial lesions. Both carotid endarterectomy was performed. and we used carotid shunt for left side during operation. Abdominal aortic lesion was operated 2 weeks later We obligately clamped aorta just below the celiac artery and infuse4 kidney perservation solution to pertect kidney during ischemia. Reversed Y bypass graft and kidney perservation was successful despite of 40 minute ischemia. Postoperative courts was uneventful and patient was discharged without any specific problem.