Dissecting Aortic Aneurysm in Childhood and Adolescence

Abstract

A 15-year-old adolescent male with dissecting aortic aneurysm is presented. His young age, lack of predisposing factors, and fulminant course with rapid progression to death precluded a correct antemortem diagnosis. Review of the literature reveals that most instances of dissecting aortic aneurysm in childhood and adolescence are associated with predisposing conditions, especially congenital cardiovascular anomalies. The clinical picture is generally characteristic. Prompt evaluation and therapy may be lifesaving.

Aortic Dissection in Childhood and Adolescence: An Analysis of Occurrences Over a 10‐Year Interval in New York State

“…32, 6, E23-E26 (2009) acceleration, horizontal deceleration, vertical deceleration, blast, compression, sudden extension of the neck, sudden traction on the shoulder, and perhaps others most likely causes the injury to the aortic wall that results in either dissection, partial tearing, or full transection. 8,24 Traumatic aortic injury has many anatomic variants. Traumatic aortic disruption can appear as a traumatic aortic intimal tear, as a subadventitial traumatic disruption of the aorta, an entity that can be subdivided into partial, subtotal, and complete varieties, and finally as a true aortic dissection, which will be termed a trauma-associated aortic dissection.…”

Aortic dissection and rupture in an 11-year-old child: A case report

“…However, mediastinal widening, pleural effusion, abnormal aortic contour, and cardiomegaly can be seen [4,5]. Even though, the patient had normal chest X-ray, we cannot exclude aortic dissection [11].…”

“…This aortic dissection is a life-threatening disease requiring early diagnosis and treatment [3]. Fikar reported that aortic dissections occur in less than 3.5% and their mortality is 0.035% in young people under 19 years old [4,5]. Untreated aortic dissection has a higher mortality rate of 1-2% hourly for the first 48 h from symptom onset.…”

“…The characteristic of migrating pain is most valuable clue for the diagnosis. Neurological symptoms affect 15-45% of patients, with confusion, weakness, and dysesthesias [5]. Moreover, high blood pressure is an important distinctive finding between children and adults, although hypertension is rare in children [2,4].…”

“…Fatal complications of type B aortic dissection include rupture of the thoracic aorta, leg ischemia, visceral ischemia, and renal failure [1][2][3][4]. The most frequent complaint is severe pain, and the characteristic of the migrating pain is the most important clue for the diagnosis [5]. The chest X-ray was normal on admission.…”