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婴儿的大型真性肱动脉动脉瘤。

A Large True Brachial Artery Aneurysm in an Infant.

机构信息

Department of Surgery, 5170University of Louisville, Louisville, KY, USA.

出版信息

Am Surg. 2022 Aug;88(8):1938-1939. doi: 10.1177/00031348221087903. Epub 2022 Apr 28.

Abstract

A 6-month-old male was admitted to the children's hospital for management of an underlying gastrointestinal illness. During his admission, a large, pulsatile mass was incidentally noted in the left upper arm concerning for an expanding pseudoaneurysm. Vascular surgery was consulted, and further workup with a CT angiogram demonstrated a brachial artery aneurysm 3 cm in greatest diameter. The patient was taken to the operating room, where lateral aneurysmorraphy was performed without complication. His neurovascular exam remained intact postoperatively. The presented case demonstrates a viable approach to the surgical management of this clinical challenge in infants. Although reports of brachial artery aneurysm in this age group are rare in the literature, resection with primary repair and interposition grafting have also been described. Long-term outcomes are not available in these cases. Lateral aneurysmorraphy allows for ongoing monitoring and future resection and bypass of the aneurysm as the patient continues to grow.

摘要

一名 6 个月大的男性因胃肠道疾病入住儿童医院。住院期间,左上肢发现一个搏动性的巨大肿块,疑似正在扩张的假性动脉瘤。血管外科医生会诊后,进一步的 CT 血管造影检查显示肱动脉动脉瘤最大直径为 3 厘米。患者被送往手术室,在那里进行了外侧动脉瘤切除术,没有出现并发症。术后他的神经血管检查仍保持完整。本病例展示了一种可行的手术方法,可用于处理婴儿的这种临床挑战。尽管文献中报道的该年龄段肱动脉动脉瘤病例很少,但也有报道称可通过切除、一期修复和中间移植来治疗。在这些病例中,无法获得长期结果。外侧动脉瘤切除术可在患者继续生长的过程中进行持续监测,并在动脉瘤继续生长时进行再次切除和旁路手术。

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