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Asymptomatic Isolated Celiac Artery Dissection After a Fall

Adam S. Gorra, MD; Derek Mittleider, MD; David E. Clark, MD, MPH; Michael Gibbs, MD
Arch Surg. 2009;144(3):279-281. doi:10.1001/archsurg.2009.22.
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Isolated injury to mesenteric vessels in blunt trauma is uncommon. Most patients with these injuries present with abdominal pain, shock, or laboratory evidence of bowel and/or liver ischemia. We report herein the case of a man with asymptomatic isolated celiac artery dissection after blunt trauma suspected by screening abdominal computed tomography and confirmed by catheter-based angiography. The patient was treated with 3 months of oral anticoagulation alone.

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Figure 1.

Contrast-enhanced sagittal computed tomographic image in the midline does not demonstrate a discrete celiac artery origin (arrow). Periarterial stranding is noted about the celiac origin.

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Figure 2.

Delayed lateral digital subtraction angiogram demonstrates opacification of the splenic artery (thick arrow) and hepatic artery (thin arrow) via collateral flow through the gastroduodenal artery (curved arrow). The celiac artery origin (arrowhead) continues to poorly opacify.

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Figure 3.

Axial computed tomographic angiogram obtained 3 months after the inciting trauma demonstrates occlusion of the celiac artery at its origin (arrow). The hepatic and splenic arteries enhance homogeneously.

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