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Volume 76 - 2013 - Fasc.3 - Case reports

Spontaneous dissection of the celiac trunk : a rare cause of abdominal pain - case report and review of the literature

Spontaneous dissection of the celiac trunk is uncommon and rarely considered in patients presenting with acute onset of epigas- tric pain. We report the case of a 48-year old male, diagnosed with a spontaneous dissection of the celiac trunk extending towards the common hepatic artery. He was treated conservatively and re- mained asymptomatic after two years of follow-up. Conservative treatment seems justified in the absence of bowel ischemia or signs of hemorrhage. Initial Computed Tomography angiography revealed the presence of a dissection with a pseudoaneurysm that remained stable and regressed towards a normal Computed Tomography angiography after 7 months of follow-up. Radiologic follow-up is warranted as progression of the dissection and/or total occlusion with or without symptoms can occur. The risk factors, the natural course and optimal treatment remain unclear due to the rarity of the disorder. Our patient had no predisposing cardio- vascular risk factors. Nevertheless, we observed a hypertrophic ligamentum arcuatum on Computed Tomography, possibly facili- tating the evolution towards a dissection. Next to the case report, we provide a review of the available literature. (Acta gastroenterol. belg., 2013, 76, 335-339).


A rare cause of dysphagia in a hiv patient - esophageal pseudodiverticulosis

Esophageal pseudodiverticulosis is a rare clinical entity with a slight male predominance (1). The condition is caused by cystic di- lation of the sub mucosal glands and hence is not true diverticulo- sis. This is usually a benign condition, affecting the distal third of esophagus. It has been associated with reflux esophagitis, strictures and candidiasis. Patients with esophageal pseudodiverticulosis may present with progressive dysphagia, though most cases are asymp- tomatic. Perforation (2), bleeding (3) and mediastinitis have rarely been described. To the best of our knowledge, the occurrence of this rare disease in hiv patients has been described only once be- fore (4). We report the second case of esophageal pseudodiverticu- losis occurring in a hiv patient. (Acta gastroenterol. belg., 2013, 76, 340-341).