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CASE REPORT
Coeliac artery dissection as a rare manifestation of Behcet’s disease
  1. Anthony J Ocon1,
  2. Vivek R Mehta2,
  3. Ruben Peredo-Wende3
  1. 1Internal Medicine, Albany Medical College, Albany, New York, USA
  2. 2Rheumatology, Albany Medical Center, Albany, New York, USA
  3. 3Division of Rheumatology, Internal Medicine, Albany Medical Center, Albany, New York, USA
  1. Correspondence to Dr Anthony J Ocon, ocona{at}amc.edu

Summary

Behcet’s disease is a multisystemic vasculitis. Arterial involvement in the form of acute dissection is rare. A 42-year-old Lebanese man with Behcet’s disease presented with severe abdominal pain. On exam, blood pressure was 162/104 mm Hg, and he exhibited epigastric tenderness. CT angiogram demonstrated an acute dissection of the coeliac artery trunk, common hepatic artery and proper hepatic arteries, with asymmetric thickening of the proximal left subclavian artery and circumferential thickening of the abdominal infrarenal aorta suggestive of vasculitis. Treatment included intravenous clevidipine, nitroprusside and methylprednisolone, which transitioned to oral metoprolol, amlodipine and prednisone. He responded well. Arterial dissections have been described with Behcet’s. We report a coeliac artery aneurysm in association with a flare of Behcet’s disease. Arterial wall inflammation combined with the sheering forces of hypertension likely predisposes to arterial dissection.

  • rheumatology
  • vasculitis
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Footnotes

  • Contributors AJO, VRM and RPW all contributed to the planning, conduct, reporting, conception and design, writing and editing of the case report. All authors took part in the case patient’s care.

  • 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 Obtained.

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

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