Presentation Title

Cocaine Induced Celiac Artery Dissection

Speaker Credentials

DO

Format

Poster

Start Date

6-11-2020 11:15 AM

End Date

6-11-2020 11:30 AM

Abstract

Introduction: Spontaneous isolated celiac artery dissection (SICAD) without associated aortic dissection is a rare clinical phenomenon that can be potentially life-threatening. It is the second leading type of visceral artery dissection after spontaneous isolated superior mesenteric artery dissection. There are only a few hundred reported cases in the literature.1 It is unclear how many cases are related to cocaine use. It is important for emergency physicians to keep this condition on their differential and to know the appropriate first steps once identified. Case Description: We present a case of a 40 year old female who presented to our emergency department with a chief complaint of abdominal pain of two days duration in the setting of recent cocaine use and was found to have a SICAD. The patient remained stable throughout her care and was transferred to another facility for further evaluation by vascular services. Patient had a good outcome with conservative management including serial imaging and pain control. Discussion: SICAD can present variably, ranging from asymptomatic incidental finding to severe pain with bowel ischemia and peritonitis. SICAD is typically detected on a CT with contrast. Some complications include aneurysm formation or occlusion. Most patients improve with conservative care including blood pressure control, pain control, as well as cessation of tobacco and illicit drugs. Surgical management can be necessary if the patient is hemodynamically unstable, develops worsening abdominal pain or the dissection is progressing.2 Conclusion: It is important to keep this vascular catastrophe on your differential considering its potential for morbidity and mortality.

This document is currently not available here.

Share

COinS
 
Nov 6th, 11:15 AM Nov 6th, 11:30 AM

Cocaine Induced Celiac Artery Dissection

Introduction: Spontaneous isolated celiac artery dissection (SICAD) without associated aortic dissection is a rare clinical phenomenon that can be potentially life-threatening. It is the second leading type of visceral artery dissection after spontaneous isolated superior mesenteric artery dissection. There are only a few hundred reported cases in the literature.1 It is unclear how many cases are related to cocaine use. It is important for emergency physicians to keep this condition on their differential and to know the appropriate first steps once identified. Case Description: We present a case of a 40 year old female who presented to our emergency department with a chief complaint of abdominal pain of two days duration in the setting of recent cocaine use and was found to have a SICAD. The patient remained stable throughout her care and was transferred to another facility for further evaluation by vascular services. Patient had a good outcome with conservative management including serial imaging and pain control. Discussion: SICAD can present variably, ranging from asymptomatic incidental finding to severe pain with bowel ischemia and peritonitis. SICAD is typically detected on a CT with contrast. Some complications include aneurysm formation or occlusion. Most patients improve with conservative care including blood pressure control, pain control, as well as cessation of tobacco and illicit drugs. Surgical management can be necessary if the patient is hemodynamically unstable, develops worsening abdominal pain or the dissection is progressing.2 Conclusion: It is important to keep this vascular catastrophe on your differential considering its potential for morbidity and mortality.