A rare and unusual cause of acute abdominal pain: A case of spontaneous isolated dissection of the celiac trunk

Poggiali, Erika; Negri, Chiara; Mosso, Federico; Petrini, Marcello; Michieletti, Emanuele; Vercelli, Alessandro

doi:10.4081/ecj.2022.10988

Cited by 1 publication

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References 6 publications

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“…According to a recent systematic review, approximately 60% of patients with CAD exhibited nonspecific clinical symptoms, such as abdominal pain, malaise, and vomiting[ 2 ]. However, SVAD is a potential diagnosis of an acute abdomen that warrants clinical concern among patients who present with persistent abdominal pain[ 8 ]. The etiology of CAD is obscure.…”

Section: Discussionmentioning

confidence: 99%

Multi-modal imaging for the diagnosis of spontaneous visceral artery dissection: A case report

Pu,

Luo

2024

World J Gastrointest Surg

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BACKGROUND Spontaneous visceral artery dissection (SVAD) is a rare condition that affects the visceral arteries, such as the celiac, superior mesenteric, and inferior mesenteric arteries, without involving the aorta. Organ ischemia or hemorrhage from vessel rupture can occur in SVAD; therefore, prompt detection and management is essential. Contrast-enhanced computed tomography (CECT) has been used to diagnose most of the previous cases, but few studies have explored the potential of contrast-enhanced ultrasound (CEUS) for early detection of this disease. CASE SUMMARY A 53-year-old male presented with complaints of poor appetite and abnormal liver function for the past 6 months. He had previously undergone transabdominal splenectomy, esophagogastric devascularization, and cholecystectomy for gallstones and severe portal hypertension. Liver ultrasound was performed in our department to assess liver status. An abnormal hepatic artery spectrum was observed, and dissection involving both the celiac artery and the common hepatic artery was observed. A CEUS was then performed and clearly showed the entry site of the intimal tear and the false lumen, and dissection was subsequently confirmed by CECT. The patient was asymptomatic; therefore, treatment to control the blood pressure was provided, and follow-up was recommended. After 6 months of follow-up, the celiac artery was found to be dilated with an adherent thrombus visible in the wall, and the common hepatic artery was occluded with the presence of collateralization. Despite these findings, no significant changes in liver function were observed. CONCLUSION Multi-modal imaging is effective in diagnosing SVAD, and conservative treatment is a choice for asymptomatic patients.

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Section: Discussionmentioning

confidence: 99%