Isolated Celiac Trunk Dissection after Cardiac Surgery

Spontaneous dissection of the superior mesenteric and inferior mesenteric arteries and of the celiac artery is uncommon occurrence [1]. Celiac artery dissection (CTD) is rare, and can present with intimal flap, mural thrombus or infiltration of fat around the artery. The causes of CTD are several and different: hypertension, arteriosclerosis, degeneration of the arterial wall, trauma, pregnancy, and arteriopathy, iatrogenic and unknown ones. The evolution of CTD isn't well known: it can be associated with complications like aneurysm formation or occlusion, splenic infarction, intraperitoneal hemorrhage and the intestinal ischemia. There are several management modalities applied by the physicians on a case by-case basis like endovascular repair or interventional radiological approach [2] or conservative treatment options by anticoagulants and anti-platelets besides antihypertensive drug are also applied. The choice of CTD isn't univocal and weedefined: according to the reported scientific paper documented CTD from 1959, the proper treatment is related to celiac trunk lesion, celiac trunk complication and patient's clinical trend. The medical treatment consists of oral anticoagulation therapy and monitoring of the patient. The medical therapy failure or the CTS complicated with widespread bowel ischemia and /or large splenic infarction needs surgery because the life-threatening development. On the contrary, a localized and mild CTD due to malperfusion or with high risk of rupture could be treated by endovascular choice.