Bansal Ashwani, Mitra Aparajita, Bisoi Akshay Kumar, Agarwala Sandeep
Department of Cardio-thoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
J Indian Assoc Pediatr Surg. 2017 Jul-Sep;22(3):176-178. doi: 10.4103/jiaps.JIAPS_258_16.
Reported here is a case of 1-year-old male child who presented with huge abdominal mass, which on radiological investigation was diagnosed as retroperitoneal pseudoaneurysm of the aorta. On exploration, it was found to be a true aneurysm of infrarenal abdominal aorta with inflow agenesis. Aneurysm was excised, and aorta was reconstructed with 10 mm Dacron graft. Postoperative computed tomography angiography showed patent graft with good distal runoff. Literature review revealed that only 26 cases of congenital abdominal aortic aneurysm had been reported so far. None of them had inflow agenesis which can give false impression of pseudoaneurysm on preoperative evaluation. The case highlights the utility of additional complimentary investigations such as Doppler study in clinching diagnosis and helping plan and execute successful treatment in the difficult diagnostic scenario.
本文报道了一例1岁男童，该患儿出现巨大腹部肿块，经影像学检查诊断为主动脉腹膜后假性动脉瘤。术中发现是肾下腹主动脉真性动脉瘤伴流入道发育不全。切除动脉瘤后，用10毫米涤纶移植物重建主动脉。术后计算机断层扫描血管造影显示移植物通畅，远端血流良好。文献综述显示，迄今为止仅报道了26例先天性腹主动脉瘤病例。其中无一例有流入道发育不全，而这在术前评估中可能会给人假性动脉瘤的假象。该病例凸显了在疑难诊断情况下，如多普勒研究等额外补充检查在确诊以及帮助制定和实施成功治疗方案方面的作用。
