Ann Surg Treat Res.  2016 Nov;91(5):265-268. 10.4174/astr.2016.91.5.265.

Right iliac arterial aneurysm in a 4-year-old girl who does not have a right external iliac artery

Affiliations
  • 1Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea. spkhy02@snu.ac.kr

Abstract

Pediatric arterial aneurysm is rare disease. Among them, idiopathic-congenital arterial aneurysm is extremely rare. This is a case report of right common iliac artery idiopathic aneurysm with absence of right external iliac artery. A 4-year-old girl who had been complaining of intermittent abdominal pain since 2 years prior presented with a right lower abdominal mass that had been palpable since 6 months prior. Abdominal CT revealed a 5.2 cm × 4.5 cm × 5.1 cm, right-sided, partially thrombosed, saccular, iliac artery aneurysm. She underwent to operation, aneurismal resection. A pathological examination confirmed that it was a true aneurysm, considering that all layers of the vascular wall were stretched with no deficit. The patient was discharged 3 days after the surgery without any complication. Five months passed since the surgery, and the patient is doing well without any abdominal or leg pain.

Keyword

Aneurysm; Iliac aneurysm; Child; Vascular surgical procedure

MeSH Terms

Abdominal Pain
Aneurysm*
Child
Child, Preschool*
Female*
Humans
Iliac Aneurysm
Iliac Artery*
Leg
Rare Diseases
Tomography, X-Ray Computed
Vascular Surgical Procedures

Figure

  • Fig. 1 Abdominal ultrasonographic image showing a 4.6 × 5.0-cm well-defined mass in the right lower quadrant.

  • Fig. 2 (A) Contrast-enhanced computed tomographic image showing communication (arrow) between the aneurysm and the internal iliac artery. (B) Schematic anatomy of the right iliac artery aneurysm without a right external iliac.

  • Fig. 3 (A) Intraoperative picture of the iliac arterial aneurysm. (B) Schematic anatomy of the intraoperative findings. The pinpoint fistula was repaired with a Prolene 6-0 suture (white arrow).

  • Fig. 4 (A) Smooth muscle actin stain [low power field, ×40] shows the all layers of the vascular wall without deficit. (B) Intimal fibroplasia (white arrow), [H&E, ×200] (C) Chronic inflammation (black arrow), [H&E, ×400].


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