Page 24 - Virtual Vascular Vol 15

Coeliac Artery Dissection

A 57 year old gentleman was admitted for left sided abdominal pain, not related

to meals. Abdomen was soft with no peritoneal signs. Blood tests and X-ray were
all normal. He tolerated oral diet and was discharged with an early CT scan:

The CT shows a coeliac artery dissection. The true lumen is indicated with blue arrow

and the false lumen with orange. The perfusion to the bowel is adequate and there is
no acute or chronic mesenteric ischemia.
He was started on Plavix and his blood pressure was optimized. The abdominal pain

resolved. Because of the risk of future aneurysmal degeneration, a follow up CT was
arranged for 1 year surveillance.
Visceral artery dissection is rare. In patients who are symptomatic, endovascular

stenting can be offered. Open coeliac axis reconstruction is rarely required.
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