Visceral artery compression syndromes

Introduction: Visceral artery compression syndromes are rare diseases with ambiguous symptoms, varying between patients.Aim: The aim of the paper was to review the disease's pathology, diagnosis and treatment.Methods: Review based on a MEDLINE database search.Results: Medial arcuate ligament syndrome (MALS) is caused by celiac trunk compression by the diaphragm's medial arcuate ligament. MALS is a diagnosis of exclusion because its symptoms are not clear-cut. Diagnostic imaging is based on Doppler ultrasound and computed tomography. Invasive treatment is aimed to decompress the celiac trunk with open, laparoscopic, or robotic methods, whereas endovascular procedures do not eliminate the disease cause. Superior mesenteric artery syndrome (SMAS) is a rare disease with symptoms resulting from compression of the duodenum between the superior mesenteric artery and the abdominal aorta. Symptoms may result from other pathologies within the abdominal cavity, therefore the diagnosis is based on exclusion of other gastrointestinal causes and on tomographic criteria. Conservative treatment is usually ineffective, while the choice of surgical methods requires individual assessment. Nutcracker syndrome (NCS) is characterized by symptoms caused by compression of the left renal vein by the superior mesenteric artery. Diagnosis is made after excluding other causes, as there are no established NCS diagnostic criteria. Doppler ultrasound and computed tomography are used in syndrome diagnosis, and its treatment should be individualized.Conclusions: The compression syndromes are rare diseases that occur significantly more frequently in women. Their diagnosis and treatment are a clinical challenge. A better pathophysiology understanding and the use of minimally invasive treatment techniques can improve the patient's quality of life.