Chapter 187 - Arterial aneurysms in pediatric Flashcards
Etiological types of pediatric aneurysms
1) infection
2) aortitis
3) arteritis
4) genetic
5) developmental
6) traumatic
Infectious pediatric aneurysms causes
1) umbilical artery catheterization
2) endocarditis
Aortitis in children types
Takayasu aortitis
stenosis first then aneurysm (asymptomatic)
Arteritis in children causes
1) Behcet
2) SLE
3) Kawasaki
4) PAN
Causes of cardiac tamponade in children
Kawasaki (coronary artery inflammation)
Genetic causes of aneurysm in children
1) Arterial tortuosity
2) Ehler-Danlos
3) Marfan
4) Loeys-Dietz
5) Tuberous sclerosis
6) Cutaneous laxa syndrome
Most common location of developmental/idiopathic aneurysms along an artery
At arterial bifurcation
Most common organism in infected pediatric aortic aneurysms
Staph aureus and albus
Other name for Kawasaki
Mucocutaneous lymph node syndrome
Characteristics of Kawasaki
1) erythematous extremity
2) fingertip desquamation
3) conjunctivitis
4) lymphadenopathy
5) coronary aneurysm 20%
6) abdominal aorta
Tuberous sclerosis key points
1) autosomal dominant
2) multiorgan: brain, retina, kidney, heart, skin
3) rare abdominal and thoracic aortic aneurysm
4) Harmatomas
5) seizures and mental retardation
6) TSC1 and TSC2 gene affected
Marfan in neonates unique feature
more aggressive than later onset
usually de novo mutation
Non-syndromic aortic aneurysms risk of rapid expansion
1) craniofacial
2) ocular
3) cutaneous
presence of these features suggest worse aneurysm course
Contraindication to closed aneurysmorrhaphy in children
1) presence of thrombus or loose fibrinous debris
2) large aneurysm where plicated wall would be difficult to collapse
De Jong definition of carotid bulb aneurysm
1) > 150% of normal CCA
2) > 200% of normal ICA
