A Cross Sectional Study on Magnitude of Incidental Vascular Compressions in Abdomen and Pelvic CT, Tikur Anbessa Hospital, Addis Abeba ,Ethiopia
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Date
2019-07
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Addis Abeba University
Abstract
Background:Certain abdominopelvic vascular structures may be compressed by adjacent
anatomic structures or may cause compression of adjacent hollow viscera. The knowledge of
these CT patterns of compression is also important because they may be asymptomatic; when
symptomatic, however, they can lead to a variety of uncommonsyndromes in the abdomen
and pelvis, including median arcuate ligament syndrome, May-Thurner syndrome, nutcracker
syndrome, superior mesenteric artery syndrome, uretero-pelvic junction obstruction, ovarian
vein syndrome, and other forms of ureteral compression. Computed tomography is
particularly useful in that it allows a comprehensive single-studyevaluation of the anatomy
and resultant morphologic changes.
Objective: To describe Abdominopelvic vascular compressions incidentally found on
computed tomography.
Method: Hospital based prospective cross sectional study was conducted at TikurAnbessa
Specialized Hospital who undergo computed tomography scan of the abdomen between
January and April 2019. The study population was all patients who undergo computed
tomography scan of the abdomen .Data was collected by evaluating abdominal Computed
Tomographic scans from Picture archiving and communication system. The data was checked
for clarity and completeness. Computerized data analysis was conducted by using SPSS
version 25.0 software.
Result:Out of 623 multi detector abdominopelvic CT (MDCT)performed between January
2019 and April 2019;a total of 513 (N = 513) patients were included in the study out of which
35(6.8%) had fulfilled imaging features of SMA compression and 33(6.4%) of the patient
fulfilled imaging features of nutcracker phenomenon and 22(4.28%) of the patients showed
celiac compression by MAL. This study group comprised 277 (54 %) females and 236 male
(46%) patients. Mean age of the patients was 38±20 (mean ± standard deviation).
Conclusion:Incidental SMA Compression of duodenum, MAL compression of celiac artery
and left renal vein compression by SMA are not uncommon and syndromic diagnosis should
not be made on radiologic diagnosis alone. The SMA compression and nutcracker sign are
usually seen together. High origin of celiac artery and low insertion of MAL are the main risk
factors for compression of celiac artery which were seen in previous studies as well
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Keywords
Vascular Compressions ,Abdomen , Pelvic CT