A useful modality of CT angiography image to identify medical emergency in isolated celiac artery dissection type I: A case report with longest follow-up and literature review

Hosaka, Seiji; Fujita, Yasuhiko; Amagai, Teruyoshi

doi:10.1016/j.radcr.2023.09.004

Cited by 1 publication

(1 citation statement)

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“…A significant change in liver function would have been an indication that the CAD may have involved the hepatic artery, resulting in inadequate blood supply to the liver, which did not occur in our case. An additional concern was the possibility of splenic infarction if inhomogeneous splenic perfusion was observed[ 13 ], which also was not an issue in our case. Endovascular treatment such as stenting is recommended if symptoms persist, dissection progresses, or the aneurysm continues to enlarge, and surgery is the last option if complications are severe or endovascular treatment fails[ 14 - 16 ].…”

Section: Discussionmentioning

confidence: 93%

Multi-modal imaging for the diagnosis of spontaneous visceral artery dissection: A case report

Pu,

Luo

2024

World J Gastrointest Surg

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BACKGROUND Spontaneous visceral artery dissection (SVAD) is a rare condition that affects the visceral arteries, such as the celiac, superior mesenteric, and inferior mesenteric arteries, without involving the aorta. Organ ischemia or hemorrhage from vessel rupture can occur in SVAD; therefore, prompt detection and management is essential. Contrast-enhanced computed tomography (CECT) has been used to diagnose most of the previous cases, but few studies have explored the potential of contrast-enhanced ultrasound (CEUS) for early detection of this disease. CASE SUMMARY A 53-year-old male presented with complaints of poor appetite and abnormal liver function for the past 6 months. He had previously undergone transabdominal splenectomy, esophagogastric devascularization, and cholecystectomy for gallstones and severe portal hypertension. Liver ultrasound was performed in our department to assess liver status. An abnormal hepatic artery spectrum was observed, and dissection involving both the celiac artery and the common hepatic artery was observed. A CEUS was then performed and clearly showed the entry site of the intimal tear and the false lumen, and dissection was subsequently confirmed by CECT. The patient was asymptomatic; therefore, treatment to control the blood pressure was provided, and follow-up was recommended. After 6 months of follow-up, the celiac artery was found to be dilated with an adherent thrombus visible in the wall, and the common hepatic artery was occluded with the presence of collateralization. Despite these findings, no significant changes in liver function were observed. CONCLUSION Multi-modal imaging is effective in diagnosing SVAD, and conservative treatment is a choice for asymptomatic patients.

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Section: Discussionmentioning

confidence: 93%