PMC10272487_01
(A-D) Contrast-enhanced abdominal computed tomography (CT) scan on admission of a 50-year-old man with isolated celiac artery dissection. The scan shows extensive dissection from the celiac trunk to the splenic, common hepatic, and gastroduodenal arteries, with reduced spleen enhancement. The right hepatic artery and cholecystic artery remain patent. (E) 3D reconstruction of the aorta and branch vessels on admission displaying major patent branches originating from the right hepatic artery (asterisk) and poor opacification of the gastroduodenal artery at the confluence of the common hepatic artery (arrowhead). (F) Contrast-enhanced abdominal CT scan on day 3 revealing a loss of the enhancement effects of the cholecystic artery, whereas the right hepatic artery with progression dissection remains patent. (G) 3D reconstruction of the aorta and branch vessels on day 5 showing poor opacification of major branches from the right hepatic artery (asterisk) and poor opacification of the gastroduodenal artery (arrowhead), indicating compromised blood flow in the right hepatic artery due to the progression of dissection and insufficient collateral circulation through the gastroduodenal artery. (H) Axial image of contrast-enhanced CT on day 5 showing poor gallbladder wall opacification with pericholecystic fluid collection. (I) Pathological examination results revealing extensive gallbladder wall necrosis with marked softening and fragility, confirming ischemic change.
AMS2-10-e857-g001.jpg
PMC10272487_01_AMS2-10-e857-g001.jpg
ams2857-fig-0001
A contrast-enhanced computed tomography (CT) scan showed extensive dissection from the celiac trunk to the splenic, common hepatic, and gastroduodenal arteries with poor spleen enhancement (Figure 1A-E), leading to the diagnosis of isolated celiac artery dissection and splenic infarction. A subsequent CT scan identified cholecystitis, characterized by decrease in the enhancement of the cholecystic artery and further dissection of the right hepatic artery (Figure 1F). Intravenous heparin administration did not improve the cholecystitis (Figure 1G,H), necessitating emergency cholecystectomy on day 5. Pathological examination confirmed extensive gallbladder wall necrosis caused by ischemic changes (Figure 1I).