Isolated dissection of the celiac artery--a case report.
Isolated arterial dissection, which occurs with the absence of aortic dissection, has been reported in carotid and renal arteries but rarely in visceral arteries. A case of isolated celiac artery dissection is reported here. A healthy 58-year-old man experienced sudden upper abdominal pain, which continued for several days. A body computed tomogram (CT) showed a multiple low-density wedge-shaped area in the spleen, which was diagnosed as splenic infarction, and an aneurysm with thrombus in the celiac artery. A selective angiogram showed dilatation of the celiac artery with wall irregularity, and proximal occlusion of the hepatic artery. The distal hepatic artery was fed by collateral arteries from the superior mesenteric artery. Splenic infarction was probably due to the embolism from the thrombus in the dissected celiac artery. The absence of other vascular lesions and causes or risks for the arterial dissection would suggest the occurrence of spontaneous dissection. The dissection of visceral arteries should be considered in diagnosing acute abdominal pain.
Second Department of Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
R
R
Matsuo
Y
Y
Ohta
Y
Y
Ohya
T
T
Kitazono
H
H
Irie
T
T
Shikata
I
I
Abe
M
M
Fujishima
D015746:Abdominal Pain / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000150:complications*; D002445:Celiac Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D003097:Collateral Circulation; D003251:Constriction, Pathologic; D004108:Dilatation, Pathologic; D006499:Hepatic Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013159:Splenic Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed