True brachial artery aneurysm in a child aged 2 years

Abstract

Congenital brachial artery true aneurysms are exceedingly rare. Most are pseudoaneurysms secondary to trauma or infection. We report a boy aged 2 years who presented with painless, pulsatile swelling on the medial aspect of the right arm, 4 cm above the elbow joint that had been present since birth. Spiral CT angiography showed a fusiform aneurysm of the distal right brachial artery with a peripheral crescent-shaped thrombus. Distal arteries were normally opacified. There was no evidence of abnormal dilation or stenosis in any other artery. The aneurysm was surgically resected, with vascularisation re-established using a reversed great saphenous vein graft. His postoperative course was uneventful. Early surgery should be performed for moderately sized to large aneurysms that recently increased in size, exhibited luminal thrombus formation or caused neurovascular distal limb compromise. Early surgery could prevent complications such as a ruptured aneurysm, thromboembolism or limb ischaemia or loss.

Grave thoraco-intestinal complication secondary to an undetected traumatic rupture of the diaphragm: a case report

“…Feco-pneumothorax due to perforation of diaphragmatically herniated colon to the pleural cavity is a rare entity, and frequently associated with a tension pneumothorax unmasking the diaphragmatic lesion weeks to decades after the initially undetected injury [ 6 , 7 ]. Nine of a total of 16 cases previously reported were secondary to perforating chest injuries [ 3 , 6 , 8 – 14 ], whereas the remaining seven cases had a history of blunt abdominal and/or thoracic injury as happened to our patient [ 4 , 7 , 15 – 19 ]. Empyema is a complication that can develop in the course of these patients, requiring secondary drainage or interventional debridement and is still associated with a mortality of 25–66% [ 3 , 4 ].…”

A Rare Case of Brachial Artery Aneurysm in a 9-Month-Old Infant

“…11 However, other reports suggest that early diagnosis and surgical management of a true aneurysm is vital to prevent possible complications such as neurological dysfunction and potential loss of limb associated with ischemia resulting from thromboembolic events and bleeding. 9,[15][16][17] There is difficulty associating the size and presence of thrombus in asymptomatic aneurysms with the risk of symptomatic progression and the development of complications. 2,9 Our report agrees with previous reports 2,9 which suggest that the morbidity associated with the treatment of these aneurysms in a specialist centre is low and surgical management should be undertaken in a semi-elective setting where possible to reduce the risk of complications associated with emergency surgery.…”

“…11 However, other reports suggest that early diagnosis and surgical management of a true aneurysm is vital to prevent possible complications such as neurological dysfunction and potential loss of limb associated with ischemia resulting from thromboembolic events and bleeding. 9,15-17…”

Vascular Reconstruction of a Brachial Artery Aneurysm Proximally to an Arteriovenous Malformation

“…The ipsilateral basilic or saphenous veins are commonly used for autogenous repair of brachial artery aneurysms due to lower morbidity and shorter operating time. 21,22 Due to the size of the ectatic proximal brachial artery, and need to preserve the existing venous drainage of the remaining forearm vascular malformation, a femoral vein interposition graft was used to repair the aneurysm. Of note, paired superficial femoral veins have been used to repair an infected abdominal aortic aneurysm with successful results.…”