Isolated celiac artery vasculitis: a cause of recurrent abdominal pain in a young adult: a case report.

Abstract

Background: Vasculitis encompasses a group of disorders characterized by inflammation of blood vessel walls, leading to diverse clinical presentations on the basis of the size and location of the affected vessels. Gastrointestinal involvement is a known feature of small- and medium-sized vessel vasculitides, typically as part of systemic inflammation. However, isolated vasculitis of the celiac artery is extremely rare and has been scarcely reported in the literature, making this case particularly novel and significant.

Case presentation: We report the case of a 35-year-old Iranian male of Persian ethnicity who presented with a 7-day history of abdominal pain localized to the epigastric and periumbilical regions, accompanied by nausea. On admission, the patient's vital signs were stable, and clinical examination was unremarkable. Laboratory findings revealed elevated C-reactive protein and erythrocyte sedimentation rate. Contrast-enhanced abdominopelvic computed tomography suggested isolated vasculitis of the celiac artery. Subsequent serological tests showed borderline positive anti-nuclear antibodies, while other specific autoantibodies were negative. On the basis of clinical and radiological findings, the patient was diagnosed with isolated celiac artery vasculitis. Treatment with oral corticosteroids for 10 days led to symptom resolution and normalization of C-reactive protein levels. A follow-up computed tomography scan performed 2 weeks after treatment completion demonstrated complete resolution of inflammatory changes with no residual abnormalities. At 6-month follow-up, the patient remained asymptomatic, with no recurrence of symptoms or complications.

Conclusion: Isolated celiac artery vasculitis is an extremely rare condition that requires high clinical suspicion for timely diagnosis. Early intervention can effectively prevent life-threatening complications and reduce morbidity. This case highlights the importance of recognizing isolated vascular inflammation as a potential diagnosis in patients presenting with unexplained abdominal pain and elevated inflammatory markers.