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Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain

Spontaneous and isolated dissection of the left gastric artery is a rare occurrence, with only a handful of cases reported in the medical literature. Clinical presentation may mimic more common intra-abdominal pathologies; however, it is imperative to identify this condition promptly due to its pote...

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Autores principales: Frey, V., Engelberger, R. P., Psathas, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10466798/
https://www.ncbi.nlm.nih.gov/pubmed/37655216
http://dx.doi.org/10.3389/fcvm.2023.1240853
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author Frey, V.
Engelberger, R. P.
Psathas, E.
author_facet Frey, V.
Engelberger, R. P.
Psathas, E.
author_sort Frey, V.
collection PubMed
description Spontaneous and isolated dissection of the left gastric artery is a rare occurrence, with only a handful of cases reported in the medical literature. Clinical presentation may mimic more common intra-abdominal pathologies; however, it is imperative to identify this condition promptly due to its potential serious consequences. This underscores the importance of maintaining a high level of clinical suspicion and including this pathology in the differential diagnosis of patients presenting with acute abdominal symptoms. Hence, this case report aims to increase awareness among clinicians about the importance of identifying and treating this rare condition promptly. A 69-year-old female experienced severe epigastric pain while attending a yoga class, prompting her admission to the emergency department 24 h later due to the persistence of her symptoms. Following imaging work-up utilizing computed tomography angiography (CTA), she was diagnosed with a dissection of the left gastric artery. Notably, there was no associated aneurysm or any evidence of ischemia in the esophageal or gastric wall. Conservative management, including low-dose aspirin and blood pressure control, was implemented. After 6 months of follow-up, CTA demonstrated expansion of the true lumen and the absence of secondary aneurysm formation, leading to discontinuation of aspirin. The management of spontaneous dissection of visceral arteries is primarily determined by the presence of complications and organ ischemia. In the case of uncomplicated visceral artery dissections, first-line treatment comprises surveillance and antiaggregation. Nevertheless, the optimal duration of antiplatelet therapy and the necessity for long-term follow-up remain unclear. Endovascular or surgical interventions should be reserved for patients exhibiting deteriorating symptoms or complications, and the decision to pursue these interventions should be made on a case-by-case basis.
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spelling pubmed-104667982023-08-31 Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain Frey, V. Engelberger, R. P. Psathas, E. Front Cardiovasc Med Cardiovascular Medicine Spontaneous and isolated dissection of the left gastric artery is a rare occurrence, with only a handful of cases reported in the medical literature. Clinical presentation may mimic more common intra-abdominal pathologies; however, it is imperative to identify this condition promptly due to its potential serious consequences. This underscores the importance of maintaining a high level of clinical suspicion and including this pathology in the differential diagnosis of patients presenting with acute abdominal symptoms. Hence, this case report aims to increase awareness among clinicians about the importance of identifying and treating this rare condition promptly. A 69-year-old female experienced severe epigastric pain while attending a yoga class, prompting her admission to the emergency department 24 h later due to the persistence of her symptoms. Following imaging work-up utilizing computed tomography angiography (CTA), she was diagnosed with a dissection of the left gastric artery. Notably, there was no associated aneurysm or any evidence of ischemia in the esophageal or gastric wall. Conservative management, including low-dose aspirin and blood pressure control, was implemented. After 6 months of follow-up, CTA demonstrated expansion of the true lumen and the absence of secondary aneurysm formation, leading to discontinuation of aspirin. The management of spontaneous dissection of visceral arteries is primarily determined by the presence of complications and organ ischemia. In the case of uncomplicated visceral artery dissections, first-line treatment comprises surveillance and antiaggregation. Nevertheless, the optimal duration of antiplatelet therapy and the necessity for long-term follow-up remain unclear. Endovascular or surgical interventions should be reserved for patients exhibiting deteriorating symptoms or complications, and the decision to pursue these interventions should be made on a case-by-case basis. Frontiers Media S.A. 2023-08-16 /pmc/articles/PMC10466798/ /pubmed/37655216 http://dx.doi.org/10.3389/fcvm.2023.1240853 Text en © 2023 Frey, Engelberger and Psathas. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Frey, V.
Engelberger, R. P.
Psathas, E.
Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
title Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
title_full Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
title_fullStr Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
title_full_unstemmed Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
title_short Case report: Isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
title_sort case report: isolated dissection of the left gastric artery: an unusual cause of acute abdominal pain
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10466798/
https://www.ncbi.nlm.nih.gov/pubmed/37655216
http://dx.doi.org/10.3389/fcvm.2023.1240853
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