Celiac Artery Dissection (CAD)

Isolated dissection of the celiac artery is rare. Celiac artery dissection is not the same as, but can be accompanied by celiac artery aneurysm.

@aas, have you been diagnosed with celiac artery dissection? What treatment is being offered?

Hi Colleen, Yes I have been diagnosed with a celiac artery dissection, at the junction of the aorta and the celiac trunk. It was discovered on a ct scan, that I had for other diagnostic reasons. I was referred to a vascular surgeon.At the moment, has advised a bi-annual monitoring of the size. I went for an ultrasound as a follow up in June, but unfortunately they were not able to get a clear image. I’m in the process of scheduling another ct shortly. I’m currently and have been asymptotic.

A bit of a paradox, isn't it @aas? You must be relieved that this was found early and before you are symptomatic so that it can be monitored. But at the same time, it's a new thing to be worried about. I would certainly ask the vascular surgeon many questions like:
- What signs or symptoms should I be watching for? (without making myself neurotic)
- Are there any physical activities or exercising I should restrict?
- What physical activity is good?
- Any other lifestyle changes I should consider?

Are you an active person? Any changes you'd like to make?

I’m a 65 year old male. Relatively good physical health. I had a ct scan 5 years prior that the tech compared with. It showed no dissection. So, it developed within that time. The surgeon hasn’t placed any limitations on me as of yet. I’ll have to see what the results of the planned scan show. I was told by the attending Dr. after I had the scan diagnosis how rare it is. Thanks for your time!

I was diagnosed with Celiac artery dissection in May 2022. I have had 3 CT scans. I've seen a rheumatologist who did genetic testing on me for connective tissue disorder which came back negative I've seen two different vascular surgeons and both of them have told me that I should not feel any pain. I have been dealing with discomfort since the initial date for finding me in the ER and was transported to another ER via ambulance. I'm completely frustrated because I keep getting pushed around or pushed to the side because there's no treatment plan for this. I just don't want to be uncomfortable I have a dull aching back and abdomen daily some days are worse than others I don't know what to do or where to turn I'm hoping I can find some help with you guys thank you

I was diagnosed with Celiac Artery Dissection last month after two visits to the ER with the worst excruciating left Flank pain. Drs thought at first it was kidney stones. After three CT scans they finally discovered what it was & that a blood clot had form. Landed me in the hospital for 9 days. I have had many test done to try and figure out the cause and nothing yet. Thankfully medicine has worked & pain is no longer there. Hope they figure something out for you. Stay positive.

I too ended up in the ER for a sharp abdominal pain on my left side mostly and my upper central abdominal. 2 different reasons. A CT scanner showed I have a hematomas from my self-injecting shots for leveling up my blood thinner level.

It was way too low and it was in danger of having a stroke or heart attack from a blood clot as my blood was too thick and taking a long time to clot.

So these injections were added to my Coumadin. The hematoma formed as a result. I was bleeding in my abdomen.

Nothing they can do about that because it’s basically an internal bruise. Hard and very painful.

While there the CT scan showed that I had a torn celiac artery aneurysm. I knew about it from my yearly sonograms and for 3 years I was told by my cardiovascular surgeon that it wasn’t growing.

The hospital I went to said “you need to go to another hospital for emergency surgery” so they packed it up and put me into a big ER on wheels and off I went and the trauma hospital.

Long story short the surgeon acknowledged the tear and said that because it wasn’t bleeding there was “no need to admit you into the hospital tonight but you will need to come back to the hospital “

“See your cardiovascular surgeon ASAP first” I called him and I was told “we have an appointment set up for your yearly sonogram and I’ll see you in March” ( 3 months away!)!

I insisted that that was not acceptable and “I need to see you ASAP”. “All hospitals say that” (ASAP). and he finally caved in and we made an appointment for 2 days. He was literally annoyed by my insistence!

When I got there I had forgotten to bring my mask and halfway through the door she stopped me and rudely said “don’t you live in an assisted living facility? I said “yeah “ and she scolded me by yelling out that “shame on them for sending you here without a mask !”

I have 3 but just forgot to grab one. After filling out some paperwork a man came out and it was the sonogram guy. He did a sonogram and then I went into an exam room and my doctor came in and was making light of my issue the whole time I was there.

“We didn’t see any tears in your aneurysm” and I said that 2 surgeons seen it and you didn’t see any?” That’s when I said “could it bleed or burst?”
“It could but don’t worry about it, it’s no big deal”

He said that “we have treatment plans for a burst or bleeding aneurysm! “I’ll see you next year!” and walked out of the room.

I made next year’s appointment and walked out feeling like I’m a walking time bomb. It could burst he said but I know that a burst or bleeding aneurysm is an emergency and needs quick treatment. They are usually fatal in many cases.

This nutty doctor was annoyed clearly that I messed up his day with other patients and now I think I should get a second or third opinion. My insurance company said they had a list that I can pick from and my PCP was absolutely of no help as his answer was “ your cardiovascular Surgeon knows you better than anyone else”.
And we left it at that as I was on the phone and he rushed me off to attend to his other patients.

Am I being a hypochondriac or is a second opinion warranted?
I feel like I just got blown off by both doctors and I’m not one to whine.

I too have a celiac dissection. It had been measuring at 1.6mm and now it is at 2.3mm. The best thing I can tell you is that YOU need to be your loudest activate! I had been diagnosed with a SMA artery dissection, but they said that I should not be feeling any pain. After 5 months of testing, surgery was performed and they were able to fix my issue. Had I(and my wife) vocalized our concerns, surgery may never have been performed and I would not be here today. Stand up for your self, say your prayers, and get the attention you need. Mayo clinic was great for me and I would recommend them to anyone!

Dan

I am currently 60 and also have a celiac artery dissection with aneurysmal dilation of the artery to 1.8cm which has been stable since 2017. At that time, I had extreme sharp abdominal pain for 2-3 days. The dissection was not seen well on the intial CT scan from that time which was performed as a regular CT abdomen and not a CTA (CT angiogram). So my diagnosis was delayed.

I have no hypertension or diabetes, my only risk factor was mildly elevated cholesterol. Now am on a high dose statin and have worked to maintain a healthy weight with moderate exercise. I am being followed with annual US. Currently, I am being seen at an academic/university tertiary care vascular surgery practice who has experience with this very uncommon problem. Would advise anyone unsatisfied with their care to seek expertise as a large academic referral center practice who have experience with this issue and the support staff such as interventional radiology to intervene if the need arises. I live in the Chicago area and my intial vascualar surgeon referral (small suburban practice in the medical group where I get my primary care) wanted to jump to surgery right away, I did not feel confortable with this, felt this guy did not have the exeperience or the ability of this group to handle this problem if things got complicated. Subsequently, I went into the city to the larger university based referral center.

I discussed with my current surgeon the "what ifs" of the future if it worsens-surgery or endovascular repair with a catheter both have their potential issues. Surgery is more definitive but longer recovery. Have heard during surgery that the celiac n. plexus around the artery would need to be mobilized if choose surgery which can result in GI complications such as hyper motility-this concerns me as dont want to be dealing with losing bowel control as I get older. Endovascular repair with stents/coils/occlusions may need to be retreated in the future if performed due to possible stenosis etc and then the normal anatomy would be altered and more difficult to deal with if surgery needed. Will cross that bridge when time comes if ever.....

As others has said, sometimes I have dark thoughts and feel like a bit of a "walking time bomb" but the data favors monitoring. I personally feel comfortable with this approach as any intervention/surgery can come with complications and now I am fine and asymptomatic. But understand others may feel differently which should be discussed with their surgeon.