CT imaging findings and endovascular management of isolated spontaneous dissecting aneurysm of celiac artery

Abstract

Isolated spontaneous dissecting aneurysm of celiac artery without concomitant involvement of aorta is a rare entity and only a few cases are reported in the literature. More cases are being detected recently with greater advancements in CT technology. Clinicians and emergency physicians should be aware of this condition and should include it in the differential diagnosis of patients who present with refractory postprandial epigastric pain, particularly in middle-aged men. We present a case of a 45-year-old male with isolated spontaneous dissecting celiac artery aneurysm, with special emphasis on CT findings and the role of endovascular management.

Outcomes of conservative management of spontaneous celiac artery dissection

“…Endovascular treatments in the acute phase were performed in 10 patients for persistent pain, including stenting in seven and embolization in three. [1][2][3]17,20,21,26 Endovascular treatments in the acute phase administered to the three patients with intraperitoneal or retroperitoneal hemorrhage (as mentioned above) included stent grafting in two and embolization in one. 1,29,32 Endovascular interventions in the chronic phase were performed for aneurysmal degeneration in four patients, which included stenting in 1 patient, stent grafting in 1, and embolization in 2.…”

A unique case of isolated, spontaneous, symptomatic celiac trunk dissection

“…There are other imaging techniques that can be used, however, including magnetic resonance (MR) imaging, conventional angiography, and Doppler sonography. 6 …”

“…There is a common approach of initial conservative treatment unless specific complications from the dissection require invasive treatment such as rupture or bowel ischemia. 5 , 6 When there is necessary treatment, the majority undergo endovascular intervention; however, some still undergo open surgical repair. We are unable to draw conclusions regarding the outcomes of surgical or endovascular management due to the nature of publication bias in cases resulting in negative outcomes.…”

Surgical treatment of celiomesenteric trunk aneurysm-7 case report

“…The saccular aneurysms with four branches in such malformed portion were found by imaging inspection (including color Doppler ultrasonography, computer tomography angiography and digital subtraction angiography) in all patients (Figures 1 and 2). Such above branches were hepatic artery, splenic artery, the left gastric artery and mesenteric artery [7,8]. The sizes of aneurysms were from 4.8 centimeter to 8 centimeter with mean 5.83±1.01 centimeter, shaped as ellipse or fusiform with mural thrombosis and spotted calcification in the aneurysm wall.…”