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Open repair of a ruptured abdominal aorta with an aortoiliac vein fistula in a 7-month-old infant and review of the literature.

ABSTRACT: Ruptured abdominal aortic aneurysms are extremely rare in the pediatric population. In this video case report, we describe the successful repair of a ruptured abdominal aortic aneurysm in a 7-month-old female infant.

SUBMITTER: Fuson OI

PROVIDER: S-EPMC10921241 | biostudies-literature | 2024 Apr

REPOSITORIES: biostudies-literature

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Open repair of a ruptured abdominal aorta with an aortoiliac vein fistula in a 7-month-old infant and review of the literature.

Fuson Olivia I OI Hirai Kelsi K Halleran Devin R DR Jafri Mubeen M Muralidaran Ashok A Azarbal Amir A Abraham Cherrie Z CZ Shalhub Sherene S

Journal of vascular surgery cases and innovative techniques 20240201 2

Ruptured abdominal aortic aneurysms are extremely rare in the pediatric population. In this video case report, we describe the successful repair of a ruptured abdominal aortic aneurysm in a 7-month-old female infant. ...[more]

PMID: 38464889

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Arteriovenous Fistula Caused by Ruptured Abdominal Aortoiliac Aneurysm.

Project description:Teaching point: A ruptured aorto-iliac aneurysm, complicated by an iliac arteriovenous fistula, is rare but has a possibly fatal outcome and requires prompt diagnosis and appropriate treatment.

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Endovascular Repair for Abdominal Aneurysm with Concomitant Aortoiliac Vein Fistula Diagnosed by Four-Dimensional Computed Tomography.

Project description:A 78-year-old man complaining of left leg swelling was diagnosed with an abdominal aortic aneurysm with an irregular margin. A four-dimensional computed tomography (CT) showed an aortoiliac vein fistula. An AFX stent graft was urgently implanted, and a Viabahn VBX was inserted into the left iliac vein. The aneurysmal sac was embolized. After the procedure, enhanced CT confirmed a patent stent graft without any endoleak or fistula. The patient was discharged ambulatory. An aortoiliac vein fistula is a differential diagnosis for leg edema, and a four-dimensional CT is beneficial in diagnosing the condition.

| S-EPMC9816039 | biostudies-literature

A Rare Case of Direct Spontaneous Carotid-Cavernous Fistula in a 6-Month-Old Infant and Review of the Literature.

Project description:Direct or type A CCFs are the direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus. While most direct CCFs are caused by trauma, spontaneous direct CCFs are extremely rare in infants. In this report, we describe a 6-month-old child with bulges in the right eye that had been present since 20 days after birth. On examination, there was a right eye abduction limitation with no deviation associated with proptosis. Bruit was present during auscultation. CEMRI showed an enlarged right cavernous sinus with dilatation of the superior ophthalmic vein, suggesting a carotid-cavernous fistula. The patient was referred to an advanced center where he was advised patch therapy to prevent amblyopia. He was kept under observation by a neurosurgeon until 3 years, after which he was scheduled to undergo transarterial coiling.

| S-EPMC10601783 | biostudies-literature

The Development of the Mind: A Three Month Old Infant.

Project description:Infant mental development occurs in interplay with a caregiver. The infant establishes an inner world, a psyche, by using his or her caregiver as transitional mental space for the development of a sense of self. This mental progress occurs simultaneously with motor elaboration, pre-conditioned by neurophysiological maturation. The bodily holding function of the caregiver, through initial skin-to-skin contact, enables the infant to develop a sense of bodily self. The pivotal role of the body as a first place of ego development is illustrated by the vignette of Nino, a 3-month-old infant whose caregiver is unable to provide the necessary physical contact, and therefore insufficiently containing the young infant. This lack of physical holding limits the infant from developing a sense of bodily self, a primary sense of self. Without the caregiver's holding function, it is impossible for the infant to establish a relationship to a whole person.

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Isolated deep orbital hemangioma treated successfully with oral propranolol in a 2-month-old infant: Case report with literature review.

Project description:PurposeInfantile hemangiomas (IH) are the most common benign vascular tumors of infancy. Ocular complications due to orbital IH include strabismal, deprivational, or anisometropic astigmatism, and visual loss secondary to amblyopia.ObservationsWe report a case of a two-month-old female infant with a severe deep orbital IH. The diagnosis was established by clinical examination and magnetic resonance imaging (MRI). The patient was treated with oral propranolol for six months. Complete tumor regression was observed clinically and by MRI following the treatment. The patient showed no adverse effects or tumor recurrence at the 14-month follow-up.Conclusions and importanceDespite its benign nature, periorbital IH requires a rapid diagnosis and prompt treatment to prevent vision loss, particularly in infants. Our case confirms that oral propranolol may be regarded as a safe drug for periorbital IH with an excellent outcome.

| S-EPMC8082548 | biostudies-literature

Group A Streptococcal Pericarditis in a Four-Month-Old Infant: Case report.

Project description:Purulent pericarditis is uncommon among paediatric patients and cases caused by group A Streptococcus (GAS) are even rarer. We report a four-month-old female infant who was referred to the Royal Hospital, Muscat, Oman, in 2015 with pericardial effusion and cardiac tamponade. She had initially presented to a secondary hospital with a two-week history of fever, a runny nose and shortness of breath. Blood and pericardial fluid cultures confirmed GAS isolates. The infant was treated with a two-week course of antibiotics and made a complete recovery with no echocardiographical evidence of pericardial effusion at a two-month follow-up. To the best of the authors' knowledge, this case constitutes the youngest infant to present with GAS pericarditis. As invasive GAS infections can present in infancy, early recognition and treatment is required.

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Lead poisoning in a 6-month-old infant: a case report.

Project description:BackgroundLead is a toxic element of the environment that leads to major complications once it enters the blood stream, affecting multiple organs and systems of the body.MethodsWe present a case of a 6-month-old female infant diagnosed with lead poisoning after presenting for routine child health care. The child's mother denied that the infant had a history of exposure to lead-containing substances. After a month of calcium supplementation, the patient's blood lead level remained elevated. We then tested the blood lead level of the mother and father. The results showed that the blood lead level of the mother was 77.0 μg/L and that of the father was 36.9 μg/L. The high blood lead level of the mother attracted our attention. We found that the mother had been using an external traditional Chinese medicine, Hu Wang Fen, which contains lead. After the mother's discontinuation of use of the traditional medicine, the child was treated with symptomatic treatment and chelation therapy. Subsequently, the patient's blood lead level decreased significantly.ResultsLead toxicity can be a life-threatening problem because of its potential for severe complications. In children, there is no safe blood lead level, and the toxic effects of lead can be prevented by the awareness and avoidance of traditional Chinese medicines that may contain lead.ConclusionEven though the diagnosis of lead poisoning remains difficult in children, it must be taken into consideration by the clinician when treating a child using traditional Chinese medicines.

| S-EPMC10194651 | biostudies-literature

A protocol-based treatment for ruptured abdominal aortic aneurysm contributed to improving aorta-related mortality: a retrospective cohort study.

Project description:BackgroundRecent guidelines state that improving the survival rate of patients with ruptured abdominal aortic aneurysm (rAAA) requires a protocol or algorithm for the emergency management of these patients. We aimed to investigate whether introducing a protocol treatment for rAAA improves clinical outcomes compared with the pre-protocol strategy.MethodsAt our institution, 92 patients treated for rAAA between June 2008 and August 2022 were retrospectively analyzed. In 2014, the protocol-based treatment was introduced comprising a transfer algorithm to shorten the time to proximal control, use of an endovascular occlusion balloon, strict indications for endovascular aortic aneurysm repair (EVAR) or open surgical repair, and perioperative care, including for abdominal compartment syndrome (ACS). Clinical outcomes were compared between the protocol and pre-protocol group, including operative status, all-cause mortality, and rAAA-related death at 30-day, in-hospital, and 1-year postoperative follow-ups.ResultsOverall, 52 and 40 patients received the protocol-based and pre-protocol treatments, respectively. EVAR was more frequently performed in the protocol group. The rate of achieving time to proximal control was significantly faster, and the transfusion volume was lower in the protocol group. ACS occurred more frequently in the protocol group with a higher EVAR. No difference was found in all-cause mortality between the two groups. The protocol group exhibited fewer rAAA-related deaths than the pre-protocol group during the following time points: 30 days (9.6% vs. 22.5%), during the hospital stay (11.5% vs. 30.0%), and 1 year (14.5% vs. 31.5%).ConclusionsThe protocol-based treatment improved the survival rate of patients with rAAA.

| S-EPMC10474727 | biostudies-literature

Extracranial Vertebral Artery-Internal Jugular Vein-Spinal Vein Fistula in Neurofibromatosis Type I: Case Report and Literature Review.

Project description:BackgroundA cervical arteriovenous fistula (AVF) in neurofibromatosis type I (NF-1) is uncommon, and it brings challenges and difficulty in treatment.Case presentationA 39-year-old woman was diagnosed with an NF-1-associated spontaneous vertebral artery-internal jugular vein-spinal vein fistula. The fistula was placed by coil embolization. Postoperative examination showed that the fistula closure was satisfied, and the patient's abnormal clinical manifestation disappeared without any complications after 24 months of interventional embolization. As per the literature, interventional embolization is currently the main treatment method, and it has the distinguishing features of less trauma, quick recovery, and a good prognosis.ConclusionNF-1 associated with a spontaneous arteriovenous fistula is rare in clinical practice, which carries significant challenges in treatment, but can be effectively treated using endovascular embolism. Endovascular embolism could be the potential choice of treatment in NF-1 associated with AVF.

| S-EPMC9104120 | biostudies-literature

Pulmonary tuberculosis presenting as lung abscess in a 10-month-Old infant.

Project description:Tuberculosis in infants although less common compared to older children and adults, is associated with a high risk for milliary tuberculosis, tuberculosis meningitis and overall higher mortality. Lung abscess commonly presents following severe community acquired bacterial infections and is extremely rare in infants with tuberculosis. This report presents the case of a 10-month-old infant who had an unusual presentation of pulmonary tuberculosis with no cough, poor growth or documented temperature >38 C despite extensive right lung involvement with lung abscess formation and pleural effusions. Inflammatory markers were minimally deranged. The diagnosis of pulmonary tuberculosis was confirmed based on positive tuberculosis polymerase chain reaction test. The child made a successful clinical and radiological recovery upon completion of anti-tuberculosis drug regimen for six months. This report brings to light that it is crucial for clinicians to have a high index of suspicion of tuberculosis irrespective of age of the patient, presenting symptoms and low prevalence since delayed diagnosis of tuberculosis in infants is associated with poor outcomes.

| S-EPMC7516287 | biostudies-literature

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