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2025 ICD-10-CM code I77.4

Celiac artery compression syndrome.

Use additional codes to specify any associated conditions, such as malnutrition or other gastrointestinal complications.

Medical necessity for surgical intervention is established by demonstrating significant impairment in quality of life due to chronic abdominal pain and other symptoms refractory to conservative management, along with clear imaging evidence of celiac artery compression. The documentation should clearly link the patient's symptoms to the anatomical compression and explain why surgical decompression is the appropriate treatment.

Diagnosis and treatment of celiac artery compression syndrome typically involve vascular surgeons, gastroenterologists, and radiologists. Vascular surgeons perform the surgical decompression of the celiac artery, while gastroenterologists manage the digestive symptoms. Radiologists play a crucial role in diagnosis by conducting imaging studies like duplex ultrasound, CT angiography, and conventional angiography to visualize the compression.

In simple words: Celiac artery compression syndrome happens when a band of tissue in your chest presses on the artery that supplies blood to your stomach area. This can cause stomach pain, especially after eating, and sometimes weight loss, nausea, and vomiting.

Celiac artery compression syndrome (CACS), also known as median arcuate ligament syndrome (MALS), Dunbar syndrome, celiac axis syndrome, or Harjola-Marable syndrome, is a rare condition where the median arcuate ligament, a fibrous band of the diaphragm, compresses the celiac artery. This compression reduces blood flow to the abdominal organs, leading to chronic abdominal pain, particularly after eating, weight loss, nausea, vomiting, and sometimes an abdominal bruit.

Example 1: A 30-year-old woman presents with chronic postprandial abdominal pain, weight loss, and an abdominal bruit. Imaging reveals compression of the celiac artery by the median arcuate ligament, leading to a diagnosis of celiac artery compression syndrome., A 45-year-old man experiences recurrent episodes of severe abdominal pain after meals, accompanied by nausea and vomiting. After ruling out other gastrointestinal conditions, a CT angiogram shows significant narrowing of the celiac artery during expiration, consistent with celiac artery compression syndrome., A young, thin woman reports persistent abdominal pain that worsens after eating and improves when leaning forward.She has also experienced significant weight loss. Duplex ultrasound examination of the celiac trunk shows a maximum expiratory peak velocity over 350 cm/s, confirming the diagnosis of celiac artery compression syndrome.

Documentation should include details of the patient's symptoms (abdominal pain, weight loss, nausea, vomiting), the duration and characteristics of the pain (postprandial, relation to posture), physical examination findings (abdominal bruit), and results of imaging studies (duplex ultrasound, CT angiography, conventional angiography) demonstrating the compression of the celiac artery by the median arcuate ligament. Any associated conditions or complications should also be documented.

** While imaging findings like focal narrowing ("J" or hooked appearance) of the celiac trunk and post-stenotic dilatation are suggestive, it's important to correlate them with clinical symptoms. Many asymptomatic individuals may have some degree of celiac artery narrowing, so a diagnosis of CACS relies on both imaging and clinical correlation. Consider using iFrameAI for further details on this code and related information, as it might provide more comprehensive and up-to-date information compared to standard references.

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