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Cocaine-induced spontaneous isolated celiac artery dissection: a case report
Anuj Timshina1, Laxman Wagle1, Santosh Katuwal1
1Department of Internal Medicine, Ascension Saint Agnes Hospital, Maryland, USA.
Introduction:
Spontaneous isolated celiac artery dissection (SICAD) without aortic involvement is a rare but potentially life-threatening condition that needs emergent care.
Case Presentation:
A 57-year-old African American male with a history of hypertension, smoking, and substance use disorder presented with sudden-onset severe abdominal pain after 30 minutes of cocaine use. Imaging confirmed isolated celiac artery dissection following recent cocaine use. The patient was managed conservatively for spontaneous isolated celiac artery dissection.
Clinical Discussion:
Spontaneous isolated celiac artery dissection, characterized by sudden-onset abdominal pain localized to the periumbilical and epigastric regions, is linked to various risk factors such as hypertension, atherosclerosis, smoking, fibromuscular dysplasia, and autoimmune disorders. Studies underscore male predominance, the distinctive nature of abdominal pain, and the efficacy of conservative management. Additionally, cocaine use has been associated with multiple vascular pathologies, including dissection.
Conclusion:
Although the occurrence of spontaneous isolated celiac artery dissection after cocaine use has not been reported, the timing of cocaine use and symptom onset is highly suggestive of the association. The use of more frequent imaging would likely uncover more cases. It is important to keep this condition on the differential when evaluating abdominal pain in patients with cocaine abuse.
