Operative Treatment of Pediatric Splanchnic Arterial Occlusive Disease

Clinical Presentation

Splanchnic arterial occlusive disease in children is a very uncommon pathologic entity and a rare cause of intestinal ischemic symptoms. This disease is usually recognized as an incidental finding during studies of hypertensive children having abdominal aortic coarctations or renal artery disease. In two earlier publications from our institution, splanchnic artery occlusive lesions were encountered in 22% of patients with abdominal aortic coarctations and in 18% of patients with renal artery stenotic disease.

An occasional child has symptomatic intestinal ischemia manifest by postprandial abdominal pain and a failure to gain or maintain weight. The diagnosis in patients with suspected intestinal angina is most often confirmed by arteriographic imaging ( Figures 1 and 2 ). The stenotic narrowings in these children invariably affect the ostia of the celiac and superior mesenteric arteries.