Patel Shivani,  Lecrone Natalie,  Mahdi Eman,  Vorona Gregory,  Jones Kathryn,  Mishra Chakradhar,  Taha Khalid

Final Pr. ID: Poster #: CR-021

Crohn’s disease is a common form of granulomatous inflammation affecting the gastrointestinal tract. Takayasu arteritis, a rare large-vessel vasculitis also known as pulseless disease, involves the inflammation, thickening, and narrowing of major arteries such as the aorta and its branches. There is evidence of a higher prevalence of Crohn's disease in patients with Takayasu arteritis, suggesting a potential link between these conditions. This case report highlights the presentation of Takayasu arteritis in a pediatric patient with Crohn’s disease, emphasizing the role of imaging in diagnosis.
An 8-year-old female with a history of Crohn’s colitis was referred to nephrology for hypertensive emergency workup. Her blood pressure was recorded at 158/97 mmHg, prompting an echocardiogram that revealed elevated left ventricular (LV) mass, LV dilatation, eccentric hypertrophy, abnormal diastolic function, and moderate aortic insufficiency—all consistent with hypertensive emergency. A CT angiogram of the chest and abdomen with IV contrast identified infrarenal aortic stenosis, a retroperitoneal soft tissue encasing the stenotic segment, and thickening of the right common carotid artery. These findings were further validated by a Carotid Doppler ultrasound, which showed right common carotid artery wall thickening (0.41cm) with less than 50% stenosis, indicative of vasculitis consistent with Takayasu arteritis. Additionally, MRI revealed diffuse mural thickening, enhancement, and diffusion restriction of the abdominal aorta, with extension to the mesenteric, renal arteries, and left common iliac artery, confirming active arteritis.
Laboratory results showed elevated inflammatory markers, including CRP (2.7), ESR (120), and IgG1 (1658). Normal IgG4 levels ruled out IgG4-related disease. The patient was started on amlodipine and atenolol for hypertension, along with solumedrol for vasculitis. Infliximab, azathioprine, aspirin, and Bactrim were also initiated for Crohn’s and vasculitis management. Read More

Authors:  Patel Shivani , Lecrone Natalie , Mahdi Eman , Vorona Gregory , Jones Kathryn , Mishra Chakradhar , Taha Khalid

Keywords:  Crohn's Disease, Vasculitis, Takayusu

Saadat Vandad,  Chawla Soni,  Chen Johnathan,  Iskander Paul,  Ghahremani Shahnaz

Final Pr. ID: Poster #: EDU-006

Awareness of abdominal aorta abnormalities in pediatric patients is essential for appropriate diagnosis and management of the patients suffering from these conditions. Due to a nonspecific presentation, and sometimes being asymptomatic earlier in life, imaging has an important role in diagnosis of these abnormalities. Aneurysm and dissection are excluded, as they are not specific to children and with few exceptions mostly present in older patients.
We review the clinical presentation and show imaging findings of mid aortic syndrome, Takayusu arteritis, rare entities such as idiopathic infantile arterial calcification. Also we show imaging of the anatomic variants of the distal aorta such as middle sacral artery, persistent sciatic artery, abdominal aorta coarctation and blind ending aorta, with a short review of embryologic development of abdominal aorta. These anomalies are not common, however if remain undiagnosed might have serious consequences.

-Midaortic syndrome is an uncommon disease with progressive narrowing of the abdominal aorta and its major branches, typically involving interrenal segment of the aorta; it affects mostly children and young adults, the cause is not clear, might be the result of an intrauterine insult to the intima and subintimal tissues. Aside from diagnosis, imaging has a major role in endovascular treatment of mid aortic syndrome.
-Takayusu arteritis, also predominantly involves aorta and its major branches of younger patients, with strong female predominance, and frequently found in Asian patients. Destruction of arterial medi leads to aneurysm formation and uncommonly rupture of the involved artery.



-Idiopathic infantile arterial calcification, a rare entity presenting with extensive calcification and stenosis of large and medium sized arteries, usually leads to early death from coronary artery occlusion.
-The aortoiliac variants are rare and not commonly discussed in the imaging literature. Some anomalies might be asymptomatic in young ages, but might complicate surgeries like heart, renal transplant, or hip surgery and increases the risk of morbidity and mortality. Some of these anomalies such as persistent sciatic artery need long term follow-up, given the possibility of aneurysmal degeneration. Read More

Authors:  Saadat Vandad , Chawla Soni , Chen Johnathan , Iskander Paul , Ghahremani Shahnaz

Keywords:  Aorta, takayusu, midaortic