Aortic dissection in children: case report and literature review.

Background: Aortic dissection is rare in both children and adults. Misdiagnosis is common because of hidden symptoms, insufficient knowledge among pediatricians, and lack of consensus and guidelines. We aimed to report the clinical features of patients and enhance the diagnostic awareness of aortic dissection in children with acute chest pain or trauma, avoid delayed diagnosis and the subsequent worsening of clinical outcomes.

Case description: We presented three cases of pediatric aortic dissection and summarized our findings from the literature. We treated a 13-year-old boy with Stanford Type A aortic dissection, a 9-year-old boy with Stanford Type B aortic dissection, and an 11-year-old boy with Stanford Type A aortic dissection. Two patients had spontaneous aortic lesions, one had a traumatic aortic lesion, and all three were discharged from our hospital after thoracotomy. We searched the Medline database using PubMed and platforms such as Springer Link and Google Scholar with the search terms "aortic dissection" and "pediatric" or "children". We retrieved 27 reports describing 34 cases of aortic dissection in patients aged ≤16 years published from 1990 to 2024 to summarize the characteristics of precipitating factors, aortic dissection status, and clinical presentations.

Conclusions: The prognosis of children with aortic dissection after treatment is generally better than that of adults. In pediatric emergency settings, persistent chest pain that does not alleviate and cannot be attributed to common illnesses warrants heightened suspicion of aortic dissection. Surgical treatment should be promptly performed once the condition is diagnosed.