Isolated celiac trunk dissection following blunt abdominal trauma: A case report and review of the literature.

Introduction: Celiac trunk dissection is an extremely rare vascular injury in the setting of blunt abdominal trauma, accounting for less than 0.01 % of all trauma cases. Despite its rarity, this condition carries significant clinical relevance due to the celiac artery's role in perfusing vital upper abdominal organs. Clinical presentation varies widely, and diagnosis is often incidental during imaging for trauma evaluation. Management strategies range from conservative therapy to endovascular or surgical intervention, depending on the clinical context.

Presentation Of Case: We report the case of a 44-year-old woman who presented to the emergency department after being struck by a vehicle. She was hemodynamically stable and reported upper abdominal pain. Contrast-enhanced CT scan revealed an isolated dissection of the celiac trunk, with preserved distal perfusion and no associated organ injury or ischemia. The patient was managed conservatively with anticoagulation, blood pressure control, and close monitoring. Her condition remained stable, and she was discharged on antiplatelet therapy. Follow-up was uneventful.

Discussion: Celiac artery dissection following blunt trauma is a diagnostic challenge due to its variable and often subtle clinical presentation. A high index of suspicion and appropriate arterial-phase CT imaging are essential for timely diagnosis. Most stable patients without ischemic complications can be managed nonoperatively, provided adequate collateral circulation exists. Endovascular or surgical interventions are reserved for patients with flow-limiting lesions, pseudoaneurysms, or hemodynamic instability.

Conclusion: Isolated celiac trunk dissection after blunt trauma is a rare but potentially serious condition. Early diagnosis, multidisciplinary evaluation, and individualized management are key to favorable outcomes. Conservative treatment is often effective in stable patients, while endovascular or surgical approaches should be considered in select cases with complications.