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Isolated spontaneous dissection of the celiac artery: report of two cases
Yutaka Takayama1, Mikiya Takao2, Takafumi Inoue2
1Department of Vascular Surgery, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan ; Department of Surgery, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan.
Insights
Spontaneous celiac artery dissection is rare. Conservative management with blood pressure control and surveillance is effective for most patients, showing no symptom recurrence.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Gastroenterology
Background:
- Isolated spontaneous dissection of the celiac artery (DCA) is an exceptionally rare vascular condition.
- Optimal therapeutic strategies for DCA remain incompletely established in current medical literature.
Observation:
- Two male patients, aged 58 and 43, presented with abdominal and back pain, respectively.
- Enhanced computed tomography confirmed spontaneous dissection of the celiac artery in both cases.
- Both patients were successfully treated with conservative management, including antihypertensive agents.
Findings:
- The patients exhibited favorable outcomes under medical management, with no recurrence of symptoms or progression of the dissection.
- Follow-up periods of 3.5 years and 3 months demonstrated sustained stability after diagnosis and treatment.
Implications:
- Conservative treatment, focusing on blood pressure control and vigilant surveillance, appears to be a viable and effective approach for the majority of DCA cases.
- This case series supports the consideration of non-interventional management for selected patients with spontaneous celiac artery dissection.
Abstract:
Isolated spontaneous dissection of the celiac artery (DCA) is extremely rare and its therapeutic strategy is still not established. We report two cases of DCA, in which 58-year-old and 43-year-old male patients with right hypogastralgia and back pain, respectively, were diagnosed by enhanced computed tomography and treated conservatively with antihypertensive agents. They were doing well under circumspect medical management without recurrence of symptoms or progression of dissection after 3.5 years and 3 months, respectively, after detection of DCA. Conservative treatment with blood pressure control and careful surveillance is considered to be applicable in most cases of DCA.
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