Kanda Kenta, Hattori Yo, Suzuki Shingo
Department of Internal Medicine, Chiba Central Medical Center, Chiba, JPN.
Department of Surgery, Chiba Central Medical Center, Chiba, JPN.
Cureus. 2025 Jul 15;17(7):e88022. doi: 10.7759/cureus.88022. eCollection 2025 Jul.
Spontaneous celiac artery dissection (SCAD) typically presents with acute abdominal or back pain, although some patients are asymptomatic. We report a case of a 75-year-old woman who experienced sudden severe epigastric pain; SCAD was diagnosed using contrast-enhanced computed tomography (CT). Conservative management resolved her symptoms. A literature review of 256 SCAD cases, including ours, revealed that most cases exhibit a sudden or acute onset and severe pain disproportionate to mild or absent tenderness, with normal D-dimer and C-reactive protein levels. These findings highlight the importance of considering SCAD in cases of unexplained severe abdominal pain, warranting contrast-enhanced CT imaging even when the laboratory results are normal.
自发性腹腔干夹层（SCAD）通常表现为急性腹痛或背痛，不过有些患者并无症状。我们报告一例75岁女性，她突发剧烈上腹部疼痛；通过增强计算机断层扫描（CT）诊断为SCAD。保守治疗使她的症状得到缓解。对包括我们这例在内的256例SCAD病例进行文献回顾发现，大多数病例起病突然或急性发作，疼痛剧烈但压痛轻微或无压痛，D-二聚体和C反应蛋白水平正常。这些发现凸显了在不明原因的严重腹痛病例中考虑SCAD的重要性，即使实验室检查结果正常，也有必要进行增强CT成像。
