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Mycotic iliac artery aneurysm with appendicitis in a pediatric patient

S P Sunil1, K Aimanan2, Z Ismazizi1

  • 1Hospital Kuala Lumpur, Department of Surgery, Kuala Lumpur, Malaysia.

The Medical Journal of Malaysia
|March 20, 2021
PubMed

Insights

Pediatric mycotic iliac aneurysms are rare. This case highlights successful management of a complex mycotic iliac aneurysm in a child using stent-graft deployment and subsequent surgical intervention.

Area of Science:

  • Vascular Surgery
  • Pediatric Cardiology
  • Infectious Diseases

Background:

  • Iliac aneurysms are uncommon in pediatric patients, with mycotic aneurysms being particularly rare.
  • Revascularization in infected fields poses challenges due to patency concerns and growth potential in children.

Observation:

  • A 12-year-old boy with a history of infective endocarditis presented with a right common iliac mycotic aneurysm.
  • Initial treatment involved balloon-expandable stent-graft deployment, followed by recurrent abdominal pain due to appendiceal inflammation and an endoleak.

Findings:

  • A second intervention included laparotomy, ligation of the right internal iliac artery, appendicectomy, and omental pedicle placement.
  • Six-month follow-up showed a patent stent-graft and no residual collection, with the patient in good health.

Implications:

  • This case demonstrates a successful multimodal approach to managing complex pediatric mycotic iliac aneurysms.
  • Effective treatment strategies are crucial for improving outcomes in rare pediatric vascular conditions.

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