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Aorto-iliac aneurysms following umbilical artery catheterization
Journal of Pediatric Surgery
|August 1, 1986
Summary
Pediatric aneurysms following umbilical artery catheterization (UAC) are linked to bacteremia, particularly Staphylococcus aureus. Catheter tip location correlates with aneurysm site, highlighting UAC as a significant risk factor in children.
Area of Science:
- Pediatric Cardiology
- Vascular Surgery
- Infectious Diseases
Background:
- Aneurysms are rare in children, typically linked to congenital heart defects.
- Umbilical artery catheterization (UAC) is increasingly associated with pediatric aneurysms.
- This study investigates UAC-related aneurysms in children.
Observation:
- Two cases of UAC-associated aneurysms were observed at the Medical College of Virginia over 8 years.
- A literature review identified 18 additional pediatric cases (totaling 20 patients).
- Aneurysms occurred in the thoracic, abdominal, and iliac arteries.
Findings:
- Umbilical artery catheterization (UAC) combined with bacteremia, especially Staphylococcus aureus, is a primary risk factor (90% of cases).
- A significant correlation exists between the UAC tip's position and the aneurysm's location (P < .05).
- These rare aneurysms are often misdiagnosed as tumors.
Implications:
- Early diagnosis of UAC-associated aneurysms is crucial, especially in children presenting with tumor-like masses and a history of UAC.
- Close monitoring of pediatric patients with Staphylococcus aureus bacteremia complicating UAC is recommended for early aneurysm detection.
- While likely mycotic, pus and graft infections have not been reported, suggesting unique pathogen behavior or presentation.