Congenital abdominal aortic aneurysm (AAA) is a rare condition in neonates. To our knowledge, the natural course of the disease in a Thai neonate has not yet been reported.
To report the characteristics and clinical course of congenital AAA in a Thai neonate.
A female Thai infant was born spontaneously at term (3,990 g) having a large, pulsatile, abdominal mass. Computed tomographic angiography (CTA) of the abdominal aorta showed a large infrarenal AAA, and a fusiform aneurysm at the left common iliac artery. Two small right renal arterial aneurysms were also noted. The large aneurysm was partially resected and a Gore-Tex vascular graft was placed at 15 days old. Histopathology of the aneurysmal wall revealed no specific etiology. Ultrasonography revealed thrombosis of the graft on the 13th day after surgery.
Repeated CTA of the abdominal aorta at age 13 mo showed complete thrombosis of the graft with reconstitution of collateral circulation. The infrarenal AAA and left common iliac aneurysm and 2 small right renal artery aneurysms were completely thrombosed. The patient grew and developed normally to the most recent follow up at age 36 mo.
Congenital AAA with failure of graft replacement may regress spontaneously.
Anongnart Sirisabya, Tanteera Tooptakong and Noppachart Limpaphayom
In 1975, King Chulalongkorn Memorial Hospital (KCMH) in Bangkok, Thailand, published data on common orthopedic problems in neonates.
To determine the more recent incidence of these conditions and to compare the results with those reported 40 years ago by KCMH. The data were also compared with a recent report from Siriraj Hospital.
We reviewed medical records of newborn infants from 2012 to 2016, all of whom were born in KCMH with deformities of upper and lower extremities or other birth-related injuries. The cases were grouped according to International Classification of Diseases, 10th edition. The incidence of common neonatal orthopedic problems was calculated as cases per 1,000 live births and compared, using a chi-squared test, with the earlier data from KCMH and with the data recently reported by Siriraj hospital.
Of the 24,825 live births, 54% were male and 46% were female. The average birth weight was 3,052.2 ± 516.1 g (range, 535–5,320 g) for infants. The most common deformity was postural clubfoot, followed by calcaneovalgus and hip dysplasia, with incidences of 1.37, 0.93 and 0.52 per 1,000 live births, respectively. The incidence of calcaneovalgus, metatarsus adductus, and clubfoot was lower than in the 1975 study and in the report from Siriraj. In all 3 studies, the incidence of birth-related injury was similar and clavicular fracture was the most common, with a rate of 1.3/1,000 live births.
The incidence of common neonatal orthopedic problems varies among institutions. Birth-related injury is a major challenge. The results may be utilized as updated data and as a starting point for parental education.