Abstract
A 61-year-old woman who had neck pain and back pain was admitted. An enhanced computed tomographic (CT) scan showed acute type A aortic dissection, and aortic dissection extended from the ascending aorta to the bilateral iliac artery. Although the celiac artery was occluded due to aortic dissection, blood flow to liver was maintained by collateral flow from the superior mesenteric artery. Therefore, she was hospitalized and received an ascending aortic replacement for acute type A aortic dissection. Although the patient had no symptom, laboratory examination showed significant elevation of serum liver enzyme levels on the third day of admission. An enhanced CT scan and angiography showed a significant decrease of blood flow to the liver because of a decrease in collateral flow. Because the patient had previously received gastrectomy, we avoided laparotomy. Thus, we chose endovascular treatment. We placed a 14.5×5 mm balloon expandable stent in the celiac trunk. The blood flow to the liver was significantly increased and serum liver enzyme level was decreased after the procedure. Her liver function recovered, and she was discharged 22 days after the procedure. We report a case of hepatic ischemia after occlusion of the celiac artery due to acute aortic dissection, and refer to the literature.
