Spontaneous Celiac Artery Dissection With Severe Pain Disproportionate to Lack of Prominent Tenderness and Limited Diagnostic Value of D-dimer and C-reactive Protein: A Case Report and Literature Review

自发性腹腔动脉夹层伴剧烈疼痛,但压痛不明显,D-二聚体和C反应蛋白的诊断价值有限:病例报告及文献综述

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Abstract

Spontaneous celiac artery dissection (SCAD) typically presents with acute abdominal or back pain, although some patients are asymptomatic. We report a case of a 75-year-old woman who experienced sudden severe epigastric pain; SCAD was diagnosed using contrast-enhanced computed tomography (CT). Conservative management resolved her symptoms. A literature review of 256 SCAD cases, including ours, revealed that most cases exhibit a sudden or acute onset and severe pain disproportionate to mild or absent tenderness, with normal D-dimer and C-reactive protein levels. These findings highlight the importance of considering SCAD in cases of unexplained severe abdominal pain, warranting contrast-enhanced CT imaging even when the laboratory results are normal.

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