No ordinary stomachache
Six years of worsening upper-abdominal pain and an elusive diagnosis were destroying Kim Barley’s life. “It felt like a heart attack every morning when I woke up,” says Barley. “It was an angina-like pain, only in the stomach. I can’t tell you how many times I was in the ER.”
Then one day, Barley’s sister, a nurse, told a colleague about Barley’s dilemma. “Has she ever had the arteries in her stomach checked?” asked the colleague. A few days later, Barley once again was rushed to the emergency room. She asked the attending physician to check her stomach arteries. Her celiac artery was 90 percent blocked – and a blood clot had formed. “They put me on blood thinners, but I wasn’t feeling much better. And they didn’t know what was causing the blockage.”
Meanwhile, Barley was losing 90 pounds. “I wasn’t able to eat correctly. I’d have to eat several small snack-type meals because food would just sit there, and I’d end up vomiting all the time.” As her appetite waned, her medical bills mounted. Her family was forced to refinance its home – twice. She took out a loan on her 401(k) plan.
Enter Daniel Clair, MD, FACS, Chairman of the Department of Vascular Surgery within the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic. Dr. Clair used a CT angiogram to find that the blockages resulted from the exceptionally strong median arcuate ligament – which is attached to the diaphragm and controls breathing – pressing against the celiac artery. “When I’d lie flat at night, the ligament pressed against the celiac artery, which feeds to the stomach, liver, pancreas and spleen,” says Barley. “My main organs were not getting proper blood flow.”
In March 2007, working with Cleveland Clinic laparoscopic surgeon Steven Rosenblatt, MD, Dr. Clair performed a laparoscopic release of the arcuate ligament compression of the celiac axis and isolation of the celiac axis. The procedure eliminated the pressure on the artery, restoring proper blood flow to the organs. At the time, Dr. Clair says only three other such cases had been reported being done in individuals in the United States.
Barley, now 37 and a bank branch manager in Westlake, Ohio, says she had the surgery on a Friday morning and returned home the next day. While it took more than a month for a full recovery, she says medical follow-up has not been necessary, and that she has been free of stomach pain.
Now, with her appetite back on track and her life back to “normal,” Barley is eager to spread the word about her experience and spare others the anguish she and her family have felt. “As I was going through all this, my kids saw me in pain every day. It was awful.”
Reviewed: 4/09