Spontaneous isolated celiac and splenic artery dissection with splenic infarction

Aciu, Shaun Pateman; Petrochko, Jameson M.; Bassik, Noy; Fisher, Jay B.

doi:10.1016/j.radcr.2022.03.060

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…After reading the full texts, 18 studies were excluded further as displayed in Figure 1. Eventually, 60 reports (53 case reports [2,3,16–66] and 7 case series [7,11,67–71] ) with 125 ICAD patients were included for detailed information in analysis. According to our definition of age group, 62 cases were young patients and 63 cases were considered as old patients.…”

Section: Resultsmentioning

confidence: 99%

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

Chen,

Wu,

Wang

et al. 2023

Medicine

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Background and aims: Though increasing studies reported the management of spontaneous isolated celiac artery dissection (ICAD), the characteristics and etiology of ICAD in different age-stage patients have not been well-studied. Our study was designed to describe and further to compare the clinical features of spontaneous ICAD between young and old patients. Methods: We searched PubMed, Embase, and Web of Science up to March 1, 2023 for spontaneous ICAD case reports. Two reviewers screened the titles and abstracts of searched records for qualified reports according to the including and excluding criteria and extracted the data independently. Statistical analysis was performed using SPSS software (version 19.0; IBM Corp, Armonk, NY) and Stata 12.0 (Stata Corp., College Station, TX). Descriptive results were presented as the mean ± standard deviation or percent. The comparison results between young and old patients were displayed as risk ratio (RR) or standardized mean difference (SMD) with its 95% confidence intervals (CI). Results: We totally identified 60 reports in the present analysis. The mean age of patients was 52.4 years, with the majority of patients being male (84.4%). The majority of patients were symptomatic and commonest presentation was abdominal pain (76.7%). Most patients (63.2%) had comorbidities or history and hypertension and smoking were the top 2 conditions with proportion of 63.3% and 40.5% respectively. When comparing young to old patients with ICAD, no significant difference was found in demographic and clinical features including sex, comorbidities/history, and symptoms. However, we found that young patients with ICAD experienced significantly longer dissection length (SMD 1.01, 95% CI 0.16–1.86; P = .015) and distance from ostium (SMD 0.96, 95% CI 0.07–1.85; P = .013), but no significant difference was observed in true lumen compression (SMD −0.39, 95% CI −1.22–0.44; P = .364). In addition, our results showed that ICAD in young patients extending more to distal arteries, including common hepatic artery/hepatic artery (RR 2.04, 95% CI 1.13–3.68; P = .01), splenic artery (RR 2.36, 95% CI 1.24–4.49; P = .017) and left gastric artery (RR 25.42; 95% CI 1.55–417.74; P = .04). Conclusions: Though spontaneous ICAD had multitudinous clinic-pathologic features, it was apt to middle-aged males and symptomatic and abdominal pain was always the commonest presentation. Hypertension and smoking were the top 2 conditions of ICAD patients. There was significant difference between young and old patients in radiographic characteristics of ICAD which may lead to different treatment and outcomes.

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Section: Resultsmentioning

confidence: 99%

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

Chen,

Wu,

Wang

et al. 2023

Medicine

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“…Anticoagulation or antiplatelet therapy can help prevent thrombosis and maintain organ perfusion; however, the criteria for use of these agents are unclear. CAD can lead to thrombus formation at the entry site or in the false lumen, which can cause stenosis of the true lumen and obstruct blood flow, resulting in organ ischemia[ 12 ]. In our case, even though the hepatic artery was occluded, we did not provide surgical treatment because the liver is an organ with a dual blood supply.…”

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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“…The clinical presentation of splenic artery dissection is variable, ranging from asymptomatic to life-threatening [11] . Symptoms in patients with splenic infarction vary from abdominal, flank, and back pain to nausea or vomiting and may be vague in identifying the primary diagnosis.…”

Section: Identify Sicad Findings With Cta To Prevent Life-threatening...mentioning

confidence: 99%

A useful modality of CT angiography image to identify medical emergency in isolated celiac artery dissection type I: A case report with longest follow-up and literature review

Hosaka,

Fujita,

Amagai

2023

Radiology Case Reports

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Spontaneous isolated celiac and splenic artery dissection with splenic infarction

Cited by 3 publications

References 24 publications

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

The characteristics and comparison between young and old patients with spontaneous isolated celiac artery dissection: Analysis based on 60 reports

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

A useful modality of CT angiography image to identify medical emergency in isolated celiac artery dissection type I: A case report with longest follow-up and literature review

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