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Case Reports
. 2023 Sep 4:39:24.
doi: 10.5758/vsi.230067.

Spontaneous Celiac Artery Dissection with Splenic Infarction: A Report of Two Cases

Suh Min Kim  1 , Hyunmin Ko  2
Affiliations
Case Reports

Spontaneous Celiac Artery Dissection with Splenic Infarction: A Report of Two Cases

Suh Min Kim et al. Vasc Specialist Int. .

Abstract

Spontaneous isolated celiac artery dissection (SICAD) is a rare condition that is characterized by sudden onset abdominal pain, typically occurring in middle-aged men. Although its clinical course is mostly benign, it may progress to true lumen occlusion. No established therapeutic guidelines are available for SICAD associated with splenic infarction. This report describes two patients who presented with sudden onset abdominal pain and were diagnosed with SICAD with splenic infarction based on computed tomography (CT) findings. Patients were treated with bowel rest and anticoagulants. After a week of medical therapy, the abdominal pain resolved. Follow-up CT revealed no progression of the dissection flap. The patients received oral anticoagulants for 3 months and did not experience any symptom recurrence. Medical therapy with anticoagulants may be considered for patients with SICAD and splenic infarction. Associated splenic infarction itself is not an indication for endovascular or surgical intervention for SICAD.

Keywords: Anticoagulants; Celiac artery; Dissection; Splenic infarction.

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Conflict of interest statement

CONFLICTS OF INTEREST

Suh Min Kim has been the associate editor of VSI since 2022. She was not involved in the review process. Otherwise, no potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Computed tomography scan revealed (A) celiac artery dissection with intraluminal hematoma (arrow) and (B) dissection extending to the common hepatic and splenic arteries (arrows) with associated splenic infarction (arrowhead).
Fig. 2
Fig. 2
Computed tomography scan acquired 1 week later revealed (A) no progression of dissection in the celiac, common hepatic, and (B) splenic arteries, along with a decrease in intraluminal hematoma (arrows). The extent of splenic infarction slightly increased (arrowheads).
Fig. 3
Fig. 3
Computed tomography scan acquired after 3 months revealed (A) partial remodeling of celiac artery dissection (arrow) and (B) complete remodeling in the common hepatic artery (arrow), along with atrophy of the previously infarcted spleen (arrowheads).
Fig. 4
Fig. 4
Computed tomography scan revealed (A) celiac artery dissection with intramural hematoma (arrow) and partial infarction of the spleen (arrowhead) and (B) dissection extending to the right hepatic artery (arrow).
Fig. 5
Fig. 5
Computed tomography scan acquired 1 week later revealed the stable extent of celiac artery dissection with an intraluminal hematoma (arrow) and a marked decrease in the extent of splenic infarction (arrowhead).
See this image and copyright information in PMC

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