True brachial artery aneurysm in a 3-year-old: A case report

True brachial artery aneurysms (TBAA) in children are exceptionally rare vascular anomalies, with fewer than 20 cases of idiopathic isolated aneurysms reported in children aged between 2 month to 18 in the medical literature. We present a rare case of a true brachial artery aneurysm in a 3-year-old child without any associated risk or systemic disease. This case adds to limited literature on TBAA and provides valuable insight for clinician managing similar case in resource limited setting.

A previously healthy 3-year-old female presented with a two-week history of progressive left upper extremity swelling. Physical examination revealed a 2 × 2 cm pulsatile mass on the medial aspect of the left proximal arm, 8 cm proximal to the medial epicondyle. CT angiography (CTA) confirmed a 1.7 × 1.6 cm saccular aneurysm of the proximal brachial artery. The patient underwent successful aneurysm repair with reconstruction using reversed great saphenous vein interposition (GSV) graft. Post-operative recovery was uneventful, with normal vascular function maintained at 3-month follow-up.

This case demonstrates the importance of early recognition and timely surgical management in paediatric arterial aneurysms. A systematic diagnostic approach with ultrasound and CTA enabled precise surgical planning. Histopathology finding support a congenital-idiopathic aneurysm, enriching our understanding of rare paediatric vascular anomalies. Autologous saphenous vein reconstruction was effective, confirming its role as the preferred conduit for paediatric vascular repairs.

Surgical management of paediatric brachial artery aneurysms using autologous vein reconstruction appears safe and effective. Early intervention may prevent potential complications while providing excellent short-term outcomes.