Duplex ultrasound as an initial imaging clue to spontaneous isolated celiac artery dissection: A case report

Spontaneous isolated celiac artery dissection is uncommon and is usually confirmed with computed tomography angiography (CTA). Duplex ultrasound may provide an initial clue when the lesion and its flow abnormalities are directly visualized. A 56-year-old woman with untreated hypertension presented with acute persistent epigastric pain radiating to the back. Color Doppler ultrasound at the celiac artery origin demonstrated an intimal flap separating the true and false lumens, with an adjacent hypoechoic component without detectable flow. Spectral Doppler sampling within the dissected segment showed a peak systolic velocity of 225 cm/s with spectral broadening. Initial CTA confirmed proximal celiac artery dissection. On short-interval repeat imaging, the maximum outer diameter at the same anatomic level increased from 8.8 mm to 9.7 mm, the true lumen became more compressed, and new false-lumen thrombosis appeared. Symptoms had not progressed; the decision to intervene was driven by imaging progression. False-lumen coil embolization and stent placement were performed. Follow-up CTA demonstrated a patent stent, preserved major branch perfusion, and no residual false-lumen opacification. In this patient, duplex ultrasound provided an initial imaging clue, whereas CTA confirmed the diagnosis, documented interval remodeling, and assessed the post-treatment anatomy.