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Spontaneous dissection of coeliac and superior mesenteric artery: double whammy
  1. Kanhai Lalani,
  2. Tom Devasia and
  3. Ganesh Paramasivam
  1. Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
  1. Correspondence to Dr Ganesh Paramasivam; ganeshbmc{at}gmail.com

Abstract

Isolated dissection of one of the mesenteric arteries without concurrent involvement of the aorta is a rare clinical entity and an unusual cause of abdominal pain. It usually involves one artery, most commonly the superior mesenteric artery (SMA) followed by the coeliac artery. We are reporting a rare case where both coeliac and SMA were showing dissection. We are reporting a case of 60-year-old hypertensive male who came with worsening abdominal pain for 5 days; CT scan showed coeliac and SMA dissection without any imaging evidence of intestinal ischaemia. He was successfully managed medically with bowel rest and anticoagulation. Two weeks of follow-up CT scan showed no progression or thrombus formation. For complicated cases, percutaneous transluminal angioplasty of a visceral artery or open surgical exploration or hybrid approach is required. However, for stable uncomplicated cases, medical therapy alone is sufficient.

  • radiology (diagnostics)
  • cardiovascular system
  • coeliac disease
  • medical management

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Footnotes

  • Contributors KL and GP had managed the case. The case was supervised by TD. KL reported the case and wrote the manuscript. Patient was under the care of TD. All authors approved the final version of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obatined.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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