title: Atypical presentation of a spontaneous coeliac artery dissection resulting in jejunal ischaemia.
abstract: We describe a case of a 59-year-old man with no significant medical history apart from a hiatus hernia and depression who presented with periumbilical pain which woke him at night. Before this he had 6 weeks of generalised abdominal pain. Blood tests were relatively normal and CT revealed some ill-defined stranding around the coeliac artery. He was diagnosed with a spontaneous coeliac artery dissection. Given the complexity of the case, a multidisciplinary team approach was adopted. He was managed conservatively and improved significantly over the next few days. Further investigations confirmed ischaemic changes to the distal duodenum and proximal jejunum. He has since been followed-up with CT scans and has had no further episodes 12 months from his initial admission.
authors.affiliation: Department of Hepatobiliary Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Jayan
authors.identifier: http://orcid.org/0000-0001-8899-6620
authors.initials: J
authors.lastname: George
authors.affiliation: Department of Hepatobiliary Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Harsh
authors.initials: H
authors.lastname: Nathani
authors.affiliation: Department of Hepatobiliary Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hu
authors.affiliation: Department of Hepatobiliary Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Al-Mukhtar
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D002445:Celiac Artery / Q000000981:diagnostic imaging*; D004386:Duodenum / Q000098:blood supply* / Q000000981:diagnostic imaging; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology*; D007583:Jejunum / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed