Isolated dissection of the celiac or superior mesenteric artery is rare. The term isolated refers to the absence of aortic dissection.
The onset may be spontaneous or related to an underlying cause (blunt trauma, cocaine use, inherited defect in connective tissue).
The patient may be symptomatic, or the diagnosis may be made incidentally from imaging studies.
Symptoms may include:
(1) abdominal and/or back pain
(2) nausea
(3) vomiting
Imaging findings:
(1) increased arterial diameter
(2) variable aneurysm
(3) variable stenosis
(4) variable thrombus
Morphology (Sun et al)
Type
patent false lumen with entry and re-entry
I
patent false lumen with entry but no re-entry (cul-de-sac)
II
thrombosis of false lumen, with ulcer-like projection
III
thrombosis of false lumen, without ulcer-like projection
IV
aneurysm
V
Subtype
true lumen patent
a
true lumen shows stenosis or thormbosis
b
Potential complications:
(1) aneurysmal rupture
(2) visceral malperfusion
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Specialty: Gastroenterology
