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Spontaneous Isolated Celiac Artery Dissection: A Case Report.

Clifford L Freeman1, Aaron J Lacy1, Aubrey Miner1

  • 1Vanderbilt University Medical Center, Department of Emergency Medicine, Nashville, Tennessee.

Clinical Practice and Cases in Emergency Medicine
|September 14, 2020
PubMed
Summary

This case report describes a 46-year-old man who presented with acute abdominal pain and was diagnosed with spontaneous isolated celiac artery dissection (SICAD). SICAD is a rare condition where the celiac artery tears without trauma. The patient was successfully treated with anticoagulation, antihypertensive therapy, and observation. The authors emphasize the importance of recognizing SICAD in emergency medicine to improve patient outcomes.

Keywords:
Spontaneous celiac artery dissectionAbdominal pain in emergency medicineVascular imaging techniquesAnticoagulation in vascular disorders

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Area of Science:

  • Vascular medicine within emergency care
  • Abdominal pain diagnostics in clinical medicine
  • Interventional cardiology and vascular imaging

Background:

Abdominal pain is a frequent clinical presentation with diverse underlying causes. While many cases are benign, some represent severe conditions requiring urgent diagnosis and treatment. Advances in diagnostic imaging have improved the detection of rare vascular disorders. Spontaneous isolated celiac artery dissection (SICAD) is a rare condition unfamiliar to many clinicians. Prior research has shown that celiac artery dissections can occur due to trauma or hypertension. However, no prior work had resolved the full clinical picture of SICAD in the absence of trauma. This gap motivated a closer examination of how SICAD presents and is managed. That uncertainty drove the need to document clinical features and treatment strategies. No prior work had resolved the full clinical picture of SICAD in the absence of trauma. This gap motivated a closer examination of how SICAD presents and is managed.

Purpose Of The Study:

The aim of this case report is to describe a rare vascular condition in an adult patient presenting with abdominal pain. The specific problem is the underrecognition of SICAD among emergency physicians. The motivation comes from the lack of detailed clinical documentation on this condition. The authors propose that SICAD should be considered in the differential diagnosis of acute abdominal pain. The authors propose that emergency physicians should recognize the signs and symptoms of SICAD. The authors propose that early identification can improve patient outcomes. The authors propose that treatment strategies should include anticoagulation and antihypertensive therapy. The authors propose that observation is an appropriate management approach in stable patients.

Main Methods:

The study describes a single case of a 46-year-old man with a chief complaint of abdominal pain. The approach included clinical evaluation and diagnostic imaging. The tools used were computed tomography (CT) scans and emergency department assessments. The design is a case report with no experimental manipulation. The data collected included patient history, physical examination findings, and imaging results. The authors used a narrative approach to present the clinical course. The authors focused on the diagnostic process and treatment decisions. The authors emphasized the importance of recognizing SICAD in clinical practice.

Main Results:

The strongest finding is the successful diagnosis of SICAD using CT imaging. The patient presented with acute abdominal pain and no history of trauma. The imaging revealed a dissection of the celiac artery without involvement of other vessels. The patient received anticoagulation therapy with heparin and warfarin. The patient was also prescribed antihypertensive medication. The patient's condition improved with conservative management. The patient remained stable during observation in the hospital. The patient was discharged after resolution of symptoms and normalization of blood pressure.

Conclusions:

The authors state that SICAD is a rare but potentially life-threatening condition. The authors state that emergency physicians should consider SICAD in patients with acute abdominal pain. The authors state that CT imaging is a valuable diagnostic tool for identifying SICAD. The authors state that anticoagulation and antihypertensive therapy are effective treatment strategies. The authors state that observation is appropriate for stable patients. The authors state that early diagnosis can prevent complications such as aneurysm formation. The authors state that awareness of SICAD can improve clinical outcomes. The authors state that further documentation of cases is needed to better understand this condition.

SICAD is a rare vascular condition where the celiac artery tears without trauma. It can cause acute abdominal pain and requires prompt diagnosis.

The patient was diagnosed using computed tomography (CT) scans, which revealed a dissection of the celiac artery.

Anticoagulation prevents further dissection and reduces the risk of aneurysm formation in patients with SICAD.

CT imaging confirmed the dissection and ruled out other causes of abdominal pain in this patient.

The patient presented with acute abdominal pain and no history of trauma or hypertension.

The authors propose that emergency physicians should consider SICAD in the differential diagnosis of acute abdominal pain.