• Hsiao-Chia Wang, Jiann-Hwa Chen, Chieh-Chien Hsiao, Chin-Ming Jeng, and Wei-Lung Chen.
• Department of Emergency Medicine, Cathay General Hospital, Taipei, Taiwan.
• Am J Emerg Med. 2013 Jun 1; 31 (6): 1000.e31000.e3-5.

AbstractEpigastralgia is a common chief compliant in the emergency department. Most of them are not fetal events, but some are life threatening such as aortic dissection or abdominal aneurysm rupture. Spontaneous visceral artery dissection is an uncommon occurrence with an unpredictable natural history and is rarely considered in the diagnosis of acute abdominal pain; however, it is as critical as aortic dissection and even easier to be ignored because of its rarity. We present a case of a 48-year-old man who presented to our emergency department with the chief concern of epigastric pain and diagnosed as having isolated spontaneous celiac artery dissection involving the hepatic artery, gastroduodenal artery, and splenic artery. Most cases required surgical intervention in previous reports; there are some, as in this case, managed well nonoperatively.

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