Pediatric Surgery Department. Parc Taulí University Hospital. Sabadell, Barcelona (Spain).
Cir Pediatr. 2021 Oct 1;34(4):223-227.
Arterial tortuosity syndrome (ATS) is an extremely rare autosomal recessive disorder of the connective tissue. It is characterized by tortuosity and elongation of medium and large arteries, with multiple disorders associated with the widespread involvement of the connective tissue.
Newborn diagnosed with ATS, with multiple vascular malformations, hiatal hernia, and bilateral inguinal hernia. He underwent surgery at three months of age. The hiatal hernia was closed, and bilateral inguinal hernia repair was performed. The inguinal hernias required up to 4 surgeries as a result of recurrences.During follow-up, the patient had retrocardiac diaphragmatic hernia. It was operated on, with subsequent incisional hernia. 8 years later, he was admitted as a result of septic shock secondary to intestinal occlusion. Emergency surgery was scheduled, demonstrating gastric herniation in the right pleural cavity, with perforation of the fundus. The patient died at the ICU 24 hours later.
The pediatric surgeon should be familiar with ATS, since it may cause multiple surgical pathologies, it is difficult to manage, and it is associated with a high risk of recurrence and complications.
动脉迂曲综合征(ATS)是一种极为罕见的常染色体隐性结缔组织疾病。其特征为中、大动脉迂曲和延长,并伴有广泛的结缔组织相关多种紊乱。
一名新生儿被诊断为 ATS,伴有多种血管畸形、膈疝和双侧腹股沟疝。他在三个月大时接受了手术。膈疝被关闭,双侧腹股沟疝被修复。由于复发,腹股沟疝需要进行多达 4 次手术。在随访过程中,患者出现了心脏后膈疝。进行了手术,随后出现切口疝。8 年后,由于继发于肠梗阻的感染性休克,他再次入院。计划进行紧急手术,显示胃疝入右侧胸腔,底部穿孔。患者在重症监护病房 24 小时后死亡。
儿科外科医生应熟悉 ATS,因为它可能导致多种外科病理,难以管理,并且与高复发和并发症风险相关。