Celiac artery dissection

Last revised by Rohit Sharma on 11 Aug 2023

Celiac artery dissection is a type of arterial dissection. Dissection of the celiac artery is rarely seen as a primary phenomenon and is most often encountered due to propagation of an aortic dissection.

Celiac artery dissection is usually iatrogenic but may also be secondary to:

The mean age of diagnosis is 55 years, with a male predominance.

Celiac artery dissection is likely to be under-reported due extensive collateral networks in the foregut making the development of small bowel ischemia infrequent and presenting symptoms varied.

Extension into the visceral arteries (e.g. splenic artery aneurysm or hepatic artery aneurysm) may lead to abdominal pain. Extension into the superior mesenteric artery can lead to bowel ischemia.

Symptoms are similar to chronic mesenteric ischemia, including post-prandial pain.

Findings include:

  • presence of an intimal flap

  • eccentric mural thrombus in the lumen

  • fat stranding around the celiac artery

Endovascular management

  • endovascular stent placement

  • endovascular fenestration

Surgical intervention

  • resection of the dissected segment with anastomosis or bypass creation

Conservative treatment

  • anticoagulation and optimization of blood pressure may be appropriate in cases with limited dissection, the aim of medical treatment is to prevent thromboembolic complications

  • aneurysm formation

  • arterial occlusion

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