Spontaneous Isolated Celiac Artery Dissection - A Case Report

Introduction: Spontaneous isolated celiac artery dissection (SICAD) is a rare condition, with an unpredictable natural history. It typically affects middle aged men with risk factors including hypertension and smoking. It can remain asymptomatic, and for many patients is detected as an incidental finding. The increasing number of reported cases over the past decade has been attributed to advances in imaging modalities. Management strategies vary depending on presentation. Case presentation: We describe a case of SICAD with atypical demographics. A 77-year-old female with no smoking history presented with progressively worsening abdominal pain. Contrast-enhanced CT revealed an isolated celiac artery dissection. She was managed medically, resulting in resolution of her symptoms and discharge. Discussion: Isolated celiac artery dissection (ICAD) may occur spontaneously or secondary to atherosclerosis, trauma, or medications. About 40% of cases are asymptomatic, while symptomatic cases usually present with abdominal pain; acute presentations suggest complications. Management is typically conservative, with blood pressure control, anticoagulation, and bowel rest; while surgery and endovascular interventions are reserved for progression or complications. Follow-up imaging is advised, but timing varies. Standardized management guidelines remain lacking. Conclusion: Despite its rarity, SICAD should be kept on the differential in older females presenting with abdominal pain. Conservative management is the first line in the uncomplicated cases and the complicated cases with splenic involvement.