Rare coexistence of isolated celiac artery dissection and superior mesenteric artery dissection: diagnosis, treatment, follow-up outcomes of a single patient and clinical implications

Spontaneous isolated celiac artery dissection (ICAD) coexisting with spontaneous isolated superior mesenteric artery dissection (ISMAD) is exceedingly rare, and the underlying etiology, natural history, and optimal management strategy remain poorly understood. We report a 58-year-old man in whom contrast-enhanced computed tomography angiography (CTA) disclosed ICAD (Sakamoto type I) coexisting with ISMAD (Sakamoto type IIIa). Conservative management resulted in complete symptom resolution. Follow-up CTA at one month demonstrated stable dissections without adverse events. A systematic review of the literature was undertaken to evaluate the impact of classification systems, timing of intervention, antithrombotic strategies, and radiologic surveillance protocols on clinical outcomes. These data indicate that meticulous conservative therapy coupled with rigorous imaging follow-up can yield favorable results in this rare clinical entity.