Systematic review of pediatric abdominal aortic aneurysms.

In 30 seconds

This PRISMA-compliant systematic review examined causes, presentation, management, and outcomes of abdominal aortic aneurysms in patients aged 18 years or younger, drawing on eligible case reports and case series. Across 77 studies and 87 patients, idiopathic congenital aneurysms were the most frequently reported etiology (50.6%); 13 patients (15%) presented with rupture. Open repair was the predominant treatment, and overall mortality was 17.2%, with deaths mainly associated with rupture or postoperative complications. The authors describe pediatric aneurysms as distinct from adult disease and call for better evidence to guide management.

Key findings

• Etiologies were idiopathic congenital (50.6%), mycotic (26.4%), genetic disorders (17.2%), and vasculitis (5.7%).
• Thirteen patients (15%) presented with rupture; nearly half of aneurysms were detected incidentally, including eight identified prenatally.
• Open surgical repair predominated (n = 74); overall mortality was 17.2%, with deaths primarily associated with rupture or postoperative complications.
• Survival was favorable among patients without rupture who underwent repair.

Why it matters

Pediatric abdominal aortic aneurysms have varied causes and presentations, and rupture or postoperative complications account for much of the reported mortality. The review highlights the importance of recognizing this condition as distinct from adult degenerative aneurysm disease. Because the evidence consists of reported cases and series and pediatric-specific guidelines are absent, the findings also underscore the need for collaborative data and long-term outcome tracking.

What to keep in mind

Evidence came from case reports and case series, limiting the strength of comparisons and conclusions about management or outcomes. The review also notes the absence of pediatric-specific guidelines and a need for long-term surveillance data.