Pu Y, Luo Y. Multi-modal imaging for the diagnosis of spontaneous visceral artery dissection: A case report. World J Gastrointest Surg 2024; 16(5): 1430-1435 [PMID: 38817294 DOI: 10.4240/wjgs.v16.i5.1430]
Corresponding Author of This Article
Yan Luo, Doctor, Professor, Department of Medical Ultrasound, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Wuhou District, Chengdu 610041, Sichuan Province, China. yanluo@scu.edu.cn
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2024; 16(5): 1430-1435 Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1430
Multi-modal imaging for the diagnosis of spontaneous visceral artery dissection: A case report
Yang Pu, Yan Luo
Yang Pu, Yan Luo, Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Pu Y supported the data collection and wrote the manuscript; Luo Y supervised the writing and revision of the manuscript. All authors have approved the final manuscript.
Supported byNational Natural Science Foundation of China, No. 82071940.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Luo, Doctor, Professor, Department of Medical Ultrasound, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Wuhou District, Chengdu 610041, Sichuan Province, China. yanluo@scu.edu.cn
Received: November 26, 2023 Revised: March 26, 2024 Accepted: April 11, 2024 Published online: May 27, 2024 Processing time: 179 Days and 6.7 Hours
Abstract
BACKGROUND
Spontaneous visceral artery dissection (SVAD) is a rare condition that affects the visceral arteries, such as the celiac, superior mesenteric, and inferior mesenteric arteries, without involving the aorta. Organ ischemia or hemorrhage from vessel rupture can occur in SVAD; therefore, prompt detection and management is essential. Contrast-enhanced computed tomography (CECT) has been used to diagnose most of the previous cases, but few studies have explored the potential of contrast-enhanced ultrasound (CEUS) for early detection of this disease.
CASE SUMMARY
A 53-year-old male presented with complaints of poor appetite and abnormal liver function for the past 6 months. He had previously undergone transabdominal splenectomy, esophagogastric devascularization, and cholecystectomy for gallstones and severe portal hypertension. Liver ultrasound was performed in our department to assess liver status. An abnormal hepatic artery spectrum was observed, and dissection involving both the celiac artery and the common hepatic artery was observed. A CEUS was then performed and clearly showed the entry site of the intimal tear and the false lumen, and dissection was subsequently confirmed by CECT. The patient was asymptomatic; therefore, treatment to control the blood pressure was provided, and follow-up was recommended. After 6 months of follow-up, the celiac artery was found to be dilated with an adherent thrombus visible in the wall, and the common hepatic artery was occluded with the presence of collateralization. Despite these findings, no significant changes in liver function were observed.
CONCLUSION
Multi-modal imaging is effective in diagnosing SVAD, and conservative treatment is a choice for asymptomatic patients.
Core Tip: Spontaneous visceral artery dissection (SVAD) is a rare condition. Imaging examinations play an important role in the diagnosis of SVAD. Contrast-enhanced computed tomography has been used to diagnose most of the previous cases, but few studies have explored the potential of contrast-enhanced ultrasound (CEUS) for early detection of this disease. In our case, CEUS was used for early detection of the dissection, which was confirmed using other imaging modalities, and the condition was successfully managed with conservative therapy. This case demonstrates the diagnostic value of multi-modal imaging for this uncommon disease.
