Spontaneous isolated coeliac artery dissection, mimicking thoracic aortic dissection: A case report

Pouryahya P, Meyer A McR, Mohotti JE. Spontaneous isolated coeliac artery dissection, mimicking thoracic aortic dissection: A case report.Med Emergency, MJEM 2016; 25:35-7.

Keywords: Aneurysm, angiography, anticoagulants therapeutic use, celiac artery injuries, pathology radiography, rupture, stents, vascular surgical procedures

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Corresponding author: Pourya POURYAHYA MD, FACEM, CCPU, GC ClinEpid

Monash Emergency Research Collaborative, Clinical Sciences at Monash Health, Monash University, Melbourne, Australia

Casey Hospital, Emergency Program, Monash Health Monash,  Australia

62-70 Kangan drive, Berwick, Victoria 3806, Australia

pourya.pouryahya@monashhealth.org

Pouryahya P, MD1,2,3 ,  Meyer A McR, MD1,3 , Mohotti JE, MD3

1) Casey hospital, Emergency Department, Program of Emergency Medicine, Monash Health, Melbourne, Australia

2) Monash Emergency Research Collaborative, Program of Emergency Medicine, Monash Health, Melbourne, Australia

3) Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia

Category: case report

Received: May 11, 2016

Revised: May 25, 2016

Accepted: June 15, 2016

There is no conflict of interest to declare

Abstract

Aortic dissection is a well-known differential diagnosis for thoracic back pain radiating to the chest. Dissection of a visceral artery is a rare condition which normally presents with abdominal pain. We describe the case of a 53-year-old hypertensive man who presented with sudden onset of sharp inter-scapular back and central chest pain without any abdominal discomfort. This pain subsided after a short period but did not completely resolve. CT angiogram with working diagnosis of thoracic artery dissection was performed. This revealed isolated coeliac artery dis-section. Patient had persistent hypertension and mild thoracic back pain. He subsequently was admitted to the hospital for blood pressure management and monitoring. This case, unlike other cases in medical literature, suggests that coeliac artery dissection can present with thoracic back/chest pain and can be managed conservatively.

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