Unveiling silent threats: incidental diagnosis and conservative management of spontaneous isolated celiac artery dissection

Spontaneous isolated celiac artery dissection (SICAD) is a rare vascular disorder involving a dissecting lesion confined to the celiac trunk, often detected incidentally due to advances in computed tomography (CT). We report the case of a 60-year-old asymptomatic woman in oncologic follow-up, in whom contrast-enhanced CT revealed a chronic isolated celiac artery dissection with a double lumen and preserved distal flow. No ischemic or aneurysmal complications were observed. Conservative management with antiplatelet therapy and strict blood pressure control was initiated, with stable CT findings at 6- and 12-month follow-up. This case highlights the central role of CT in diagnosing, characterizing, and monitoring SICAD. Current evidence supports a conservative approach in asymptomatic patients, reserving endovascular intervention for complicated or progressive cases. Integration of advanced imaging protocols and updated vascular guidelines enables precise risk stratification and reduces unnecessary invasive procedures, improving patient outcomes.