Splenic infarction as a complication of celiac artery thromboembolism: an unusual cause of abdominal pain

Simultaneous occurrence of five prothrombotic induced vaso-occlusive phenomena and focal nodular hyperplasia due to prolonged use of combined oral contraceptive pills

This is a rare case of a patient simultaneously presenting with five complications associated with the prolonged (5 years) use of combined oral contraceptives. The two main ingredients of combined oral contraceptives responsible for thromboembolism are estrogen (estradiol) and progestogen (progestin). Progestins are linked with occlusion of arteries while estrogens can induce both arterial and venous thrombosis. This case represents a patient with portal vein thrombosis, superior mesenteric vein thrombosis, coeliac artery occlusion, splenic and jejunal infarction and focal nodular hyperplasia.

Ischemic Necrosis of the Gastric Remnant without Splenic Infarction Following Subtotal Gastrectomy

Gastric remnant necrosis after a subtotal gastrectomy is an extremely uncommon complication due to the rich vascular supply of the stomach. Despite its rareness, it must be carefully addressed considering the significant mortality rate associated with this condition. Patients vulnerable to ischemic vascular disease in particular need closer attention and should be treated more cautiously. When gastric remnant necrosis is suspected, an urgent endoscopic examination must be performed. We report a case of gastric remnant necrosis following a subtotal gastrectomy and discuss possible risk factors associated with this complication.

Spontaneous dissection of celiac trunk with concurrent splenic artery dissection

Isolated spontaneous dissection of the celiac trunk is rarely diagnosed in acute abdominal pain. We present two cases of celiac trunk and splenic artery dissection with splenic infarction. Patients were successfully managed and stabilized by medical treatment. Isolated celiac trunk dissection can be fatal, therefore providers should be careful not to overlook this entity.