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Splanchnic artery pseudo-aneurysms secondary to blunt abdominal trauma in children
K W Gow1, J J Murphy, G K Blair
1Department of Surgery, British Columbia's Children's Hospital, Vancouver, Canada.
Insights
Traumatic splanchnic artery pseudoaneurysms are rare pediatric complications of blunt abdominal trauma. Management requires individualized approaches based on clinical presentation and lesion type.
Area of Science:
- Pediatric Surgery
- Vascular Surgery
- Trauma Surgery
Background:
- Traumatic splanchnic artery pseudoaneurysms are rare, particularly in pediatric populations.
- Blunt abdominal trauma can lead to these potentially life-threatening vascular injuries.
Observation:
- This study details four pediatric cases of splanchnic artery pseudoaneurysms following blunt abdominal trauma.
- Two cases involved splenic artery pseudoaneurysms after splenic injuries, both resolving spontaneously.
- Two cases involved hepatic artery pseudoaneurysms after liver lacerations, requiring intervention.
Findings:
- Splenic artery pseudoaneurysms in children may resolve spontaneously with observation.
- Hepatic artery pseudoaneurysms may necessitate prompt intervention, such as embolization or ligation.
- Successful outcomes were achieved in all four pediatric patients.
Implications:
- Individualized management strategies are crucial for traumatic splanchnic artery pseudoaneurysms in children.
- Early recognition and tailored treatment can lead to complete recovery without sequelae.
- Further research into optimal pediatric management protocols is warranted.
Abstract:
Traumatic splanchnic artery pseudo-aneurysms are uncommon; only two cases have been reported among the pediatric population. The authors describe their experience with four patients in whom splanchnic artery pseudoaneurysms developed after blunt abdominal trauma. Splenic artery pseudo-aneurysms were found in a 6-year-old boy and an 8-year-old girl after blunt splenic injuries. In both cases, spontaneous thrombosis of the pseudo-aneurysms occurred after a period of observation. Hepatic artery pseudoaneurysms were found in a 7-year-old boy and a 10-year-old girl after major liver lacerations. The boy had successful angiographic embolization of the lesion, but the girl required direct ligation of the pseudo-aneurysm after nearly exsanguinating from acute hemorrhage. All four children have recovered completely, with no long-term sequelae. Traumatic splanchnic artery pseudo-aneurysms are potentially life-threatening complications that can occur after blunt abdominal trauma. The investigation and management of these lesions must be individualized according to the clinical scenario.