Abdominal pain as the presenting symptom of Takayasu arteritis in an adolescent male: A case report. Issue 26 (June 2018) - Yang, Shaobo
Abstract: Rationale: Takayasu arteritis (TA) is a chronic granulomatous inflammation affecting the aorta and its main branches. The clinical symptoms are mainly due to arterial claudication and end-organ ischaemia. Abdominal pain is an uncommon manifestation of TA. Patient concerns: We present a rare case of TA in a 13-year-old boy who first presented with abdominal pain. An emergency aortic stent implantation and aneurysm embolization were performed, and the intra-operative diagnosis was aortic pseudoaneurysm. Diagnoses: A consultation with the department of rheumatism determined that the diagnosis was Takayasu arteritis according to the medical history, physical examination and auxiliary examination results. Interventions: The patient was transferred to the department of rheumatism for treatment with prednisolone and cyclophosphamide. Outcomes: Six months after the initial presentation, he was doing well clinically with no additional vascular involvement, and his blood pressure had been stabilized with oral antihypertensive drugs. Lessons: More detailed examinations of children with acute abdominal pain should be performed. Abdominal computed tomography (CT) should be administered, peripheral impulses and arterial bruits should be checked, and blood pressure among the four limbs should be monitored to rule out plausible emergencies such as an aneurysm caused by TA.