Spontaneous Celiac Artery Dissection With Severe Pain Disproportionate to Lack of Prominent Tenderness and Limited Diagnostic Value of D-dimer and C-reactive Protein: A Case Report and Literature Review.

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.