Abdominal aortic injuries are rare in the pediatric population and typically occur from motor vehicle crashes or other blunt trauma, and are associated with significant morbidity and mortality. Due to their infrequent nature, guidelines for treating these patients are not as well established and generally are treated on a case-by-case basis. In this case report, a previously healthy 9-year-old female presented to the emergency department with suspected abdominal aortic injury from a lap belt after a head on motor vehicle collision and was subsequently diagnosed with a contained abdominal aortic rupture at the L2 level with associated lumbar spinal fractures. In this patient, there was partial indication to place the stent to stabilize the aorta in preparation for the spinal surgery, as well as to treat the primary aortic injury. After multidisciplinary discussion, the aortic irregularity was successfully treated with the Gore Viabahn VBX® (10mm x 39mm, able to size up to 13mm) stent and there was no post-intervention evidence of ongoing aortic leaking. At three months, the patient remained in stable condition without evidence of mesenteric or exertional ischemia. Endovascular stents are now standard of care in the repair of post-traumatic adult vascular injuries. Unfortunately, long term follow-up data for endovascular stent grafts in children is lacking, and this patient will likely require stent graft dilation as the remainder of her aorta increases in diameter. In addition, stent grafts are not designed for pediatric use, so extra consideration needs to be given to the size and profile of the stent as to not cause deployment injury, and to be aware of the relative shortening of the stent following dilation as the aorta increases in diameter. This report reviews a case of a traumatic contained abdominal aortic rupture with an associated spinal fracture requiring surgery at the same level, with further need for bowel repair and hemicolectomy. An endovascular stent graft was determined to be optimal for immediate stabilization of the aorta and to allow subsequent spinal and laparoscopic abdominal surgeries that followed Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Risch Mary, Desai Sudhen

Keywords: Contained Aortic Rupture, Pediatric, Stent Graft