Int J Surg Case Rep. 2025 Nov;136:112051. doi: 10.1016/j.ijscr.2025.112051. Epub 2025 Oct 10.

INTRODUCTION AND IMPORTANCE: Spontaneous celiac trunk dissection (SCTD) is a rare (0.08 % of arterial dissections) but potentially life-threatening vascular emergency. It is often underdiagnosed due to its subtle presentation and uncommon nature. While hypertension and connective tissue disorders are known risk factors, the vascular toxicity of chemotherapy is an emerging concern.

CASE PRESENTATION: We report a case of SCTD in a 59-year-old male with metastatic colon cancer, who developed symptoms during treatment with FOLFIRI and cetuximab. Despite well-controlled hypertension and no significant vascular history, the dissection occurred shortly after chemotherapy administration, Imaging confirmed diagnosis without ischemia.

CLINICAL DISCUSSION: The close temporal relationship between chemotherapy and symptom onset raises the possibility of chemotherapy-induced endothelial injury as a contributing factor. Imaging confirmed the diagnosis, and the patient was successfully managed conservatively without surgical or endovascular intervention.

CONCLUSION: This case suggests FOLFIRI/cetuximab may trigger SCTD, emphasizing the need for vascular awareness in cancer patients with atypical abdominal pain.

PubMed:41332067 | DOI:10.1016/j.ijscr.2025.112051