Chronic Left Gastric Artery and Acute Superior Mesenteric Artery Dissections During a Hypertensive Crisis.

Spontaneous visceral artery dissections are rare and poorly understood presentations. Isolated superior mesenteric artery (SMA) and left gastric artery (LGA) involvement is exceptionally uncommon. Concurrent dissections are exceedingly anomalous and diagnostically challenging. We present a 74-year-old man in hypertensive crisis with severe abdominal pain. Computed tomography angiography revealed a chronic LGA dissection with aneurysm and an SMA dissection. Despite high-risk vascular findings, he was stabilized with aggressive blood pressure control and antithrombotic therapy. This case highlights the importance of early imaging and management in patients who present in hypertensive crisis with abdominal pain out of proportion to examination.