Guelbi Mohamed, Hajri Mohamed, Atallah Aziz, Hadrich Zied, Mestiri Hafedh, Omrani Sahir
Department of Surgery, Mongi Slim Hospital, Marsa, Tunisia.
Trauma Case Rep. 2025 Aug 19;59:101244. doi: 10.1016/j.tcr.2025.101244. eCollection 2025 Oct.
Celiac trunk dissection is an extremely rare vascular injury in the setting of blunt abdominal trauma, accounting for less than 0.01 % of all trauma cases. Despite its rarity, this condition carries significant clinical relevance due to the celiac artery's role in perfusing vital upper abdominal organs. Clinical presentation varies widely, and diagnosis is often incidental during imaging for trauma evaluation. Management strategies range from conservative therapy to endovascular or surgical intervention, depending on the clinical context.
We report the case of a 44-year-old woman who presented to the emergency department after being struck by a vehicle. She was hemodynamically stable and reported upper abdominal pain. Contrast-enhanced CT scan revealed an isolated dissection of the celiac trunk, with preserved distal perfusion and no associated organ injury or ischemia. The patient was managed conservatively with anticoagulation, blood pressure control, and close monitoring. Her condition remained stable, and she was discharged on antiplatelet therapy. Follow-up was uneventful.
Celiac artery dissection following blunt trauma is a diagnostic challenge due to its variable and often subtle clinical presentation. A high index of suspicion and appropriate arterial-phase CT imaging are essential for timely diagnosis. Most stable patients without ischemic complications can be managed nonoperatively, provided adequate collateral circulation exists. Endovascular or surgical interventions are reserved for patients with flow-limiting lesions, pseudoaneurysms, or hemodynamic instability.
Isolated celiac trunk dissection after blunt trauma is a rare but potentially serious condition. Early diagnosis, multidisciplinary evaluation, and individualized management are key to favorable outcomes. Conservative treatment is often effective in stable patients, while endovascular or surgical approaches should be considered in select cases with complications.
腹腔干夹层是钝性腹部创伤中极为罕见的血管损伤,占所有创伤病例的比例不到0.01%。尽管其罕见,但由于腹腔干在灌注上腹部重要器官方面的作用,这种情况具有重要的临床意义。临床表现差异很大,诊断通常在创伤评估的影像学检查中偶然发现。治疗策略根据临床情况从保守治疗到血管内或手术干预不等。
我们报告一例44岁女性患者,她在被车辆撞击后就诊于急诊科。她血流动力学稳定,自述上腹部疼痛。增强CT扫描显示腹腔干孤立性夹层,远端灌注保留,无相关器官损伤或缺血。患者接受抗凝、血压控制和密切监测的保守治疗。她的病情保持稳定,出院时接受抗血小板治疗。随访情况良好。
钝性创伤后腹腔动脉夹层因其临床表现多变且往往不明显,是一个诊断难题。高度的怀疑指数和适当的动脉期CT成像对于及时诊断至关重要。大多数没有缺血并发症的稳定患者,如果有足够的侧支循环,可以进行非手术治疗。血管内或手术干预适用于有血流受限病变、假性动脉瘤或血流动力学不稳定的患者。
钝性创伤后孤立性腹腔干夹层是一种罕见但可能严重的情况。早期诊断、多学科评估和个体化治疗是取得良好预后的关键。保守治疗对稳定患者通常有效,而对于有并发症的特定病例应考虑血管内或手术方法。