# Endovascular Treatment With a Balloon-Expandable Covered Stent in a Polytrauma 12-Year-Old Patient With Traumatic Abdominal Aortic Rupture

## TL;DR

A 12-year-old boy with a rare abdominal aortic rupture from a car accident was successfully treated with a minimally invasive stent procedure instead of open surgery.

## Contribution

This case presents endovascular stenting as a novel and feasible treatment for traumatic abdominal aortic rupture in a pediatric patient.

## Key findings

- Endovascular stent placement successfully managed the abdominal aortic rupture in a 12-year-old with polytrauma.
- The patient tolerated the procedure well with no complications during the postoperative period.
- Conservative treatment of associated injuries was effective without the need for further surgery.

## Abstract

Βlunt trauma is a common injury in children; however, blunt abdominal aortic trauma is extremely rare and is accompanied by high rates of morbidity and mortality. We report our initial experience with the endovascular management of an abdominal aortic rupture in a 12-year-old boy after he was involved in a motor vehicle accident. The patient was a backseat-restrained passenger. Upon admission, he had a Glasgow Coma Scale of 15, was hemodynamically stable, and complained of abdominal pain. The computed tomography revealed a rupture in the abdominal aorta along with a distally extending pseudoaneurysm, free fluid in the peritoneal cavity, and a large retroperitoneal hematoma. The rest associated injuries were a Grade III splenic injury, a retroclival epidural hematoma in the first cervical vertebra level, a right clavicle fracture, a bilateral minor pneumothorax, along with bilateral pulmonary lacerations and contusions in the thoracic vertebrae. Given the extent of the intraabdominal injuries and the risk for open laparotomy, the decision to proceed with endovascular stenting instead of open surgical repair was made. The patient tolerated the procedure well and an angiography confirmed the result. The postoperative period was uneventful and the associated injuries were treated conservatively without complications. Although blunt abdominal aortic trauma is extremely rare in children, endovascular management seems to be a new and feasible therapeutic approach.