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Aortic dissection
Case Detail
| Anatomy: Vascular-Lymphatic |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Trauma |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
US
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Activities:  PDF  ImageJA |
History
Premature infant with diminished lower extremity pulses.
Case Images
Diagnosis
Aortic dissection secondary to umbilical artery catheter.
Clinical Notes
Recent umbilical artery catheter placement.
Findings
Mural thickening and increased echogenicity of the infrarenal aorta with resultant luminal narrowing.
Discussion
While improved catheter construction and placement techniques have improved, catheter complications remain real and can be especially significant in fragile premature newborns. Complications of umbilical catheters include infection, thrombosis and vascular injury. Vascular injury can result in dissesction, pseudoaneurym formation, end-organ ischemia and vessel rupture. In this case, disruption of the intima led to separation of the intima and media by exposure to pressurized blood giving rise to an intramural hematoma and luminal narrowing.