Congenital Abdominal Aortic Aneurysm in Children: A Case Report and Literature Review_West China Medical Journal

Authors：

ZHANG Deshuang ^1,2 , WANG Yamei ¹ , CHEN Juan ¹ ,  TAO Yuhong. ¹

1. Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan, P. R. China; 2. Department of Neonatology, the Affiliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan, P. R. China.;

Corresponding?author：

TAO Yuhong., Email: bzhmczhdsh@163.com

Keywords：

主動脈瘤，腹; 先天性; 兒童; 多層螺旋CT血管成像; 手術治療

DOI：

10.7507/1002-0179.20130500

Video：

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目的　提高對先天性腹主動脈瘤（AAA）的認識。方法　報道2012年11月1日先天性AAA 1 例，回顧國內外報道的24 例先天性AAA的臨床資料。結果　患兒男，2歲，以肉眼血尿起病，伴高血壓、蛋白尿和反復血小板降低；多層螺旋CT血管成像（MSCTA）見AAA伴左腎動脈狹窄；彩色多普勒超聲見AAA累及雙側髂總動脈伴動脈壁間血栓及鈣化，左腎萎縮；保守治療7個月后猝死，臨終前頭顱CT見腦梗死。回顧分析24例先天性AAA，包括腎下型AAA 15 例，腎上型AAA 5例，胸腹部AAA 2例，未具體指明類型2例；產前診斷6例，出生后診斷18例（其中包括新生兒5例和1個月～3歲嬰幼兒8例）；以腹部搏動性包塊起病8 例，嘔吐4 例，呼吸困難2例，腰部疼痛1例，因其他疾病就診3例；采用血管超聲21例，MSCTA 16例，磁共振血管造影9例；13例腎下型AAA接受手術治療；死于AAA破裂5例，死于心力衰竭2例。結論　先天性AAA以腎下型為主，多為嬰幼兒，常表現為腹部腫塊，確診該病首選MSCTA，主張行早期個體化手術。

Citation： ZHANG Deshuang,WANG Yamei,CHEN Juan,TAO Yuhong.. Congenital Abdominal Aortic Aneurysm in Children: A Case Report and Literature Review. West China Medical Journal, 2013, 28(10): 1586-1589. doi: 10.7507/1002-0179.20130500 Copy

1.	Howorth MB Jr. Aneurysm of abdominal aorta in the newborn infant. Report of case[J]. N Engl J Med, 1967, 276(20): 1133-1134.
2.	Buddingh KT, Zeebregts CJ, Tilanus ME, et al. Large neonatal thoracoabdominal aneurysm: case report and review of the literature [J]. J Pediatr Surg, 2008, 43(7): 1361-1364.
3.	Dittrick K, Allmendinger N, Wolpert L, et al. Calcified abdominal aortic aneurysm in a 12-year-old boy[J]. J Pediatr Surg, 2002, 37(9): E24.
4.	Kim JI, Lee W, Kim SJ, et al. Primary congenital abdominal aortic aneurysm: a case report with perinatal serial follow-up imaging[J]. Pediatr Radiol, 2008, 38(11): 1249-1252.
5.	Odagiri S, Yoshida Y, Kawahara H, et al. Abdominal aortic aneurysm in a 3-year-old child: a case report and review of the Japanese-language literature[J]. Surgery, 1989, 106 (3): 481-485.
6.	Saad SA, May A. Abdominal aortic aneurysm in a neonate[J]. J Pediatr Surg, 1991, 26(12): 1423-1424.
7.	Mehall JR, Saltzman DA, Chandler JC, et al. Congenital abdominal aortic aneurysm in the infant: case report and review of the literature[J]. J Pediatr Surg, 2001, 36(4): 657-658.
8.	Malee MP, Carr S, Rubin LP, et al. Prenatal ultrasound diagnosis of abdominal aortic aneurysm with fibrotic occlusion in aortic branch vessels[J]. Prenat Diagn, 1997, 17(5): 479-482.
9.	Kim ES, Caiati JM, Tu J, et al. Congenital abdominal aortic aneurysm causing renovascular hypertension, cardiomyopathy, and death in a 19-day-old neonate[J]. J Pediatr Surg, 2001, 36(9): 1445-1449.
10.	Laing AJ, Hussey AJ, Joyce MR, et al. Ruptured abdominal aortic aneurysm in a 12-month-old boy[J]. J Pediatr Surg, 2002, 37(8): 1234-1235.
11.	Bell P, Mantor C, Jacocks MA. Congenital abdominal aortic aneurysm: a case report[J]. J Vasc Surg, 2003, 38(1): 190-193.
12.	Cheung SC, Khong PL, Chiu W, et al. Congenital abdominal aortic aneurysm and renal dysplasia[J]. Pediatr Radiol, 2004, 34(10): 827-830.
13.	Meyers RL, Lowichik A, Kraiss LW, et al. Aortoiliac reconstruction in infants and toddlers: replacement with decellularized branched pulmonary artery allograft[J]. J Pediatr Surg, 2006, 41(1): 226-229.
14.	Malikov S, Delarue A, Fais PO, et al. Anatomical repair of a congenital aneurysm of the distal abdominal aorta in a newborn[J]. J Vasc Surg, 2009, 50(5): 1181-1184.
15.	Cantinotti M, Luchi C, Assanta N. Prenatal diagnosis of abdominal aortic aneurysm[J]. Pediatr Cardiol, 2010, 31(1): 155-156.
16.	Tsunematsu R, Shinozaki T, Fukushima K, et al. Congenital abdominal aortic aneurysm with porencephaly: a case report[J]. Fetal Diagn Ther, 2011, 29(3): 248-252.
17.	Ye C, Yin H, Lin Y, et al. Abdominal aorta aneurysms in children: single-center experience of six patients[J]. Ann Thorac Surg, 2012, 93(1): 201-205.
18.	McAteer J, Ricca R, Johansen KH, et al. Extensive congenital abdominal aortic aneurysm and renovascular disease in the neonate[J]. J Vasc Surg, 2012, 55(6): 1762-1765.
19.	成華, 劉云召. 小兒腹主動脈瘤合并馬蹄腎畸形1例[J]. 中國實用兒科雜志, 2004, 19(9): 524.
20.	薛潔皓. 小兒巨大腹主動脈瘤1例[J]. 中華胸心血管外科雜志, 2003, 19(4): 247.
21.	喻茂彬, 楊志輝. 先天性腹主動脈瘤1例[J]. 中國冶金工業醫學雜志, 2007, 24(3): 384.
22.	黃小勇, 黃連軍, 濮欣, 等. 多排螺旋CT血管成像多種重建方法在腹主動脈瘤術前影像學評估中的應用[J]. 介入放射學雜志, 2011, 20(6): 482-486.
23.	景在平, 陸清聲. 腹主動脈瘤的治療進程[J]. 中華外科雜志, 2011, 49(10): 865.
24.	Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovascular repair of ruptured abdominal aortic aneurysms: systematic literature review[J]. Vascular, 2008, 16(4): 219-224.
25.	Steinke TM, Reber PU, Hakki H, et al. Haematuria and an abdominal aortic aneurysm--warning of an aortocaval fistula[J]. Eur J Vasc Endovasc Surg, 1999, 18(6): 530-531.
26.	蘇宏斌, 周興立, 郭曙光, 等. 血管內支架置入術治療腹主動脈瘤合并左腎動脈狹窄一例[J]. 中國現代普通外科進展, 2009, 12(2): 166-167.

1. 　Howorth MB Jr. Aneurysm of abdominal aorta in the newborn infant. Report of case[J]. N Engl J Med, 1967, 276(20): 1133-1134.
2. 　Buddingh KT, Zeebregts CJ, Tilanus ME, et al. Large neonatal thoracoabdominal aneurysm: case report and review of the literature [J]. J Pediatr Surg, 2008, 43(7): 1361-1364.
3. 　Dittrick K, Allmendinger N, Wolpert L, et al. Calcified abdominal aortic aneurysm in a 12-year-old boy[J]. J Pediatr Surg, 2002, 37(9): E24.
4. 　Kim JI, Lee W, Kim SJ, et al. Primary congenital abdominal aortic aneurysm: a case report with perinatal serial follow-up imaging[J]. Pediatr Radiol, 2008, 38(11): 1249-1252.
5. 　Odagiri S, Yoshida Y, Kawahara H, et al. Abdominal aortic aneurysm in a 3-year-old child: a case report and review of the Japanese-language literature[J]. Surgery, 1989, 106 (3): 481-485.
6. 　Saad SA, May A. Abdominal aortic aneurysm in a neonate[J]. J Pediatr Surg, 1991, 26(12): 1423-1424.
7. 　Mehall JR, Saltzman DA, Chandler JC, et al. Congenital abdominal aortic aneurysm in the infant: case report and review of the literature[J]. J Pediatr Surg, 2001, 36(4): 657-658.
8. 　Malee MP, Carr S, Rubin LP, et al. Prenatal ultrasound diagnosis of abdominal aortic aneurysm with fibrotic occlusion in aortic branch vessels[J]. Prenat Diagn, 1997, 17(5): 479-482.
9. 　Kim ES, Caiati JM, Tu J, et al. Congenital abdominal aortic aneurysm causing renovascular hypertension, cardiomyopathy, and death in a 19-day-old neonate[J]. J Pediatr Surg, 2001, 36(9): 1445-1449.
10. 　Laing AJ, Hussey AJ, Joyce MR, et al. Ruptured abdominal aortic aneurysm in a 12-month-old boy[J]. J Pediatr Surg, 2002, 37(8): 1234-1235.
11. 　Bell P, Mantor C, Jacocks MA. Congenital abdominal aortic aneurysm: a case report[J]. J Vasc Surg, 2003, 38(1): 190-193.
12. 　Cheung SC, Khong PL, Chiu W, et al. Congenital abdominal aortic aneurysm and renal dysplasia[J]. Pediatr Radiol, 2004, 34(10): 827-830.
13. 　Meyers RL, Lowichik A, Kraiss LW, et al. Aortoiliac reconstruction in infants and toddlers: replacement with decellularized branched pulmonary artery allograft[J]. J Pediatr Surg, 2006, 41(1): 226-229.
14. 　Malikov S, Delarue A, Fais PO, et al. Anatomical repair of a congenital aneurysm of the distal abdominal aorta in a newborn[J]. J Vasc Surg, 2009, 50(5): 1181-1184.
15. 　Cantinotti M, Luchi C, Assanta N. Prenatal diagnosis of abdominal aortic aneurysm[J]. Pediatr Cardiol, 2010, 31(1): 155-156.
16. 　Tsunematsu R, Shinozaki T, Fukushima K, et al. Congenital abdominal aortic aneurysm with porencephaly: a case report[J]. Fetal Diagn Ther, 2011, 29(3): 248-252.
17. 　Ye C, Yin H, Lin Y, et al. Abdominal aorta aneurysms in children: single-center experience of six patients[J]. Ann Thorac Surg, 2012, 93(1): 201-205.
18. 　McAteer J, Ricca R, Johansen KH, et al. Extensive congenital abdominal aortic aneurysm and renovascular disease in the neonate[J]. J Vasc Surg, 2012, 55(6): 1762-1765.
19. 　成華, 劉云召. 小兒腹主動脈瘤合并馬蹄腎畸形1例[J]. 中國實用兒科雜志, 2004, 19(9): 524.
20. 　薛潔皓. 小兒巨大腹主動脈瘤1例[J]. 中華胸心血管外科雜志, 2003, 19(4): 247.
21. 　喻茂彬, 楊志輝. 先天性腹主動脈瘤1例[J]. 中國冶金工業醫學雜志, 2007, 24(3): 384.
22. 　黃小勇, 黃連軍, 濮欣, 等. 多排螺旋CT血管成像多種重建方法在腹主動脈瘤術前影像學評估中的應用[J]. 介入放射學雜志, 2011, 20(6): 482-486.
23. 　景在平, 陸清聲. 腹主動脈瘤的治療進程[J]. 中華外科雜志, 2011, 49(10): 865.
24. 　Azizzadeh A, Villa MA, Miller CC 3rd, et al. Endovascular repair of ruptured abdominal aortic aneurysms: systematic literature review[J]. Vascular, 2008, 16(4): 219-224.
25. 　Steinke TM, Reber PU, Hakki H, et al. Haematuria and an abdominal aortic aneurysm--warning of an aortocaval fistula[J]. Eur J Vasc Endovasc Surg, 1999, 18(6): 530-531.
26. 　蘇宏斌, 周興立, 郭曙光, 等. 血管內支架置入術治療腹主動脈瘤合并左腎動脈狹窄一例[J]. 中國現代普通外科進展, 2009, 12(2): 166-167.

West China Medical Journal

Congenital Abdominal Aortic Aneurysm in Children: A Case Report and Literature Review

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