Traumatic Transverse Aortic Arch Pseudoaneurysm in a Pediatric Patient

BACKGROUND: Transverse thoracic aortic injuries are rare in the pediatric population compared with the incidence seen in adults. CASE SUMMARY: An 11-year-old boy sustained a severe crush to the chest, leading to a transverse aortic arch pseudoaneurysm (TAAP) and other injuries. Medical hemodynamic management was instituted to heal injuries. After 8 weeks, he underwent surgical repair with a 22-mm Dacron graft and had a full recovery. DISCUSSION: TAAP requires rapid diagnosis and intervention. Using dynamic computed tomography for preoperative planning, the grade III TAAP involved over 50% of the aortic circumference. Although data are limited, delayed repair with strict blood pressure control and serial imaging is recommended in pediatric aortic trauma. Endovascular repair was not feasible, so a surgical graft placement to accommodate future growth was chosen. TAKE-HOME MESSAGE: This case emphasizes the importance of multidisciplinary management in TAAP while adapting adult guidelines for pediatric treatment.