title: Acute Renal and Hepatic Failure in an Adolescent: An Unusual Presentation of Multiple Aortic Aneurysms.
abstract: Aortic dissection secondary to thoracoabdominal aortic aneurysms is very uncommon in children, and this life-threatening diagnosis requires a high clinical index of suspicion. Unlike adults, in whom atherosclerosis, inflammation, and advanced age are typically contributing factors, aortic dissection in children is usually due to nonatherosclerotic causes.Aortic aneurysms can be asymptomatic when small but, when significantly enlarged, can compromise organ function and dissect, resulting in high mortality rates. It is therefore critical that children with this uncommon condition be identified early when medical or surgical management can potentially improve outcome. We describe a 15-year-old patient with multiple aortic aneurysms with dissection whose presentation includes chronic anemia, acute-on-chronic renal failure with hyperkalemia, and liver injury.
authors.affiliation: From the *Department of Anesthesiology and Critical Care Medicine, Division of Pediatric Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD; †Divisions of Critical Care Medicine and Anesthesiology and Perioperative Medicine, Children's National Medical Center, Washington, DC; and ‡Department of Anesthesiology and Critical Care Medicine & Pediatrics, Division of Pediatric Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
authors.forename: Rajeev S
authors.initials: RS
authors.lastname: Wadia
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Schwartz
authors.forename: Sapna R
authors.initials: SR
authors.lastname: Kudchadkar
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications* / Q000175:diagnosis; D000293:Adolescent; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D001019:Aortic Rupture / Q000150:complications* / Q000175:diagnosis; D017809:Fatal Outcome; D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications* / Q000175:diagnosis; D008297:Male