CLINICAL CASE OF AN ISOLATED DISSECTION OF THE CELIAC TRUNK

Abstract

Symptomatic spontaneous isolated celiac artery dissection is a rare disease, with very few reported cases, which often remains undiagnosed. Contrast-enhanced computer tomography (CECT) scan is considered the primary technique for diagnosing celiac artery dissection, altough magnetic resonance imaging and conventional angiography can also be used. We describe the case of an 86-years old woman with several episodes of epigastric pain during the last month. The pain occurred at rest, without a distinct provoking factor and unrelated to food intake. We decided to perform a CECT, which revealed a penetrating atherosclerotic ulcer (PAU) in the proximal part of the celiac trunk and an intimal flap distal from it. Due to the persisting symptoms, we decided to treat the patient by endovascular approach via implantation of a covered stent. After a period of approximately 6 months, in which the patient was asymptomatic, we performed a control CT scan, which showed preserved patency of the stent and normal blood flow to the celiac branches. Currently there is no consensus as to whether surgical or endovascular treatment is more appropriate, but our case suggest that endovascular aproach can be feasible and less invasive solution.