Jornal Vascular Brasileiro
https://app.periodikos.com.br/journal/jvb/article/doi/10.1590/1677-5449.202300301
Jornal Vascular Brasileiro
Case Report

Síndrome de Dunbar - relato de caso

Dunbar syndrome - case report

Sarah Maria Lemos de Campos; Rafael Prado Pessoa; João Paulo de Araújo Pelegrini; Henrique Fernandes Silveira; Maria Fernanda Lopes Diniz; Maria Passos Bianchini; Leonardo Soares Lopes; Marcus Eduardo Valadares Meireles Martins da Costa

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Resumo

  A síndrome de Dunbar constitui um diagnóstico de exclusão dentro dos quadros de dor abdominal. O tratamento cirúrgico consiste na dissecção completa do ligamento e do gânglio nervoso circundante. Dessa forma, o presente caso refere-se a um paciente do sexo masculino, 45 anos, previamente hígido, com queixa de dor abdominal epigástrica com irradiação para o dorso e fraqueza. Inicialmente, foi realizada tomografia computadorizada de abdome para complementação do quadro, que evidenciou arteriopatia do tronco celíaco e da artéria mesentérica em associação com estenose. Optou-se por tratamento cirúrgico devido à refratariedade da dor, mas os achados foram inespecíficos. Houve necessidade de complementação da propedêutica com angiotomografia seriada para acompanhamento do caso. Após cerca de 6 meses, notou-se espessamento do ligamento arqueado, com compressão do terço proximal do tronco celíaco e estenose de 80%. Em meio a esse cenário, o paciente foi submetido a laparoscopia para descompressão do tronco celíaco, evoluindo satisfatoriamente no pós-operatório.

Palavras-chave

ligamento, Dunbar, tronco celíaco

Abstract

Dunbar syndrome is diagnosed by excluding other possible causes of abdominal pains. Surgical treatment comprises complete dissection of the ligament and the surrounding nerve ganglion. This report describes the case of a previously healthy 45-year-old male patient who presented with epigastric abdominal pain irradiating to the back and weakness. Initially, abdominal computed tomography was ordered, showing arteriopathy of the celiac trunk and mesenteric artery with stenosis. The patient underwent surgical treatment because of the refractory pain, but findings were nonspecific. It was necessary to continue workup with serial angiotomography to follow the case. After around 6 months, thickening of the arcuate ligament was found, with compression of the proximal third of the celiac trunk and 80% stenosis. The patient therefore underwent laparoscopy to relieve celiac trunk compression, with satisfactory postoperative recovery.

Keywords

ligament; Dunbar; celiac trunk

References

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Submitted date:
02/27/2023

Accepted date:
05/04/2023

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