A Case of Isolated Spontaneous Celiac Artery Dissection

Abstract

Isolated spontaneous celiac artery dissection is a rare entity, and there is still no consensus or guidelines available. A 42-year-old man presented with sudden upper left quadrant pain radiating to his left back. Physical examinations did not reveal signs of peritoneal irritation in the left upper quadrant, but only mild tenderness. Laboratory tests showed no abnormal findings other than leukocytosis. An emergency abdominal dynamic computed tomography (CT) showed the celiac artery dissected from its radix, with the proper hepatic artery occluded at its origin. We diagnosed it as isolated spontaneous celiac artery dissection, and began antihypertensive therapy as conservative treatment because his vital signs and general appearance were stable and liver functions were normal. Abdominal pain was reduced in a few days, and the patient left the hospital on the 17th hospital day. Six months later, another CT showed a spindle aneurysm of the common hepatic artery 17 mm in diameter, but after two years it did not become larger. We reviewed the literature on 68 isolated spontaneous celiac artery dissections.