Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report

Abstract Background Coarctation of the aorta is a congenital cardiovascular anomaly characterized by aortic narrowing, typically presenting in early life. This report describes an exceptionally rare case of severe abdominal aortic coarctation with extensive collateral vessel formation in an asymptom...

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Main Authors: Zhiwei Zhong, Weimin Zhou
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-025-05282-3
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author Zhiwei Zhong
Weimin Zhou
author_facet Zhiwei Zhong
Weimin Zhou
author_sort Zhiwei Zhong
collection DOAJ
description Abstract Background Coarctation of the aorta is a congenital cardiovascular anomaly characterized by aortic narrowing, typically presenting in early life. This report describes an exceptionally rare case of severe abdominal aortic coarctation with extensive collateral vessel formation in an asymptomatic 80-year-old male, underscoring the importance of recognizing delayed presentations and compensatory mechanisms. This report describes a case of severe abdominal aortic narrowing and significant compensatory dilatation of visceral arteries in an elderly male, along with a review of pertinent literature. Case presentation An 80-year-old Han Chinese male with a 10-year history of hypertension controlled with medical management (maximum blood pressure 150/90 mmHg) was incidentally diagnosed with near-occlusion of the upper abdominal aorta during routine physical examination. Computed tomography angiography revealed severe stenosis of the abdominal aorta measuring 7 mm in diameter at its narrowest segment, accompanied by marked compensatory dilatation of the superior mesenteric, inferior mesenteric, and celiac arteries (maximum diameter: 1.4 cm), forming extensive collaterals. Physical examination showed preserved dorsalis pedis pulses and no symptoms of ischemia. Given his asymptomatic status, advanced age, and robust collateral circulation, conservative management with ongoing surveillance was pursued. Conclusion This case illustrates the potential for advanced coarctation of the aorta to remain asymptomatic in elderly patients owing to compensatory vascular adaptation. It highlights the need for heightened clinical suspicion in patients with hypertension and individualized management strategies balancing risks of intervention against natural history.
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spelling doaj-art-092b2925d73b4de3808da242fe294be22025-08-20T03:10:17ZengBMCJournal of Medical Case Reports1752-19472025-05-011911510.1186/s13256-025-05282-3Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case reportZhiwei Zhong0Weimin Zhou1Department of Vascular Surgery, The Second Affiliated Hospital of Nanchang UniversityDepartment of Vascular Surgery, The Second Affiliated Hospital of Nanchang UniversityAbstract Background Coarctation of the aorta is a congenital cardiovascular anomaly characterized by aortic narrowing, typically presenting in early life. This report describes an exceptionally rare case of severe abdominal aortic coarctation with extensive collateral vessel formation in an asymptomatic 80-year-old male, underscoring the importance of recognizing delayed presentations and compensatory mechanisms. This report describes a case of severe abdominal aortic narrowing and significant compensatory dilatation of visceral arteries in an elderly male, along with a review of pertinent literature. Case presentation An 80-year-old Han Chinese male with a 10-year history of hypertension controlled with medical management (maximum blood pressure 150/90 mmHg) was incidentally diagnosed with near-occlusion of the upper abdominal aorta during routine physical examination. Computed tomography angiography revealed severe stenosis of the abdominal aorta measuring 7 mm in diameter at its narrowest segment, accompanied by marked compensatory dilatation of the superior mesenteric, inferior mesenteric, and celiac arteries (maximum diameter: 1.4 cm), forming extensive collaterals. Physical examination showed preserved dorsalis pedis pulses and no symptoms of ischemia. Given his asymptomatic status, advanced age, and robust collateral circulation, conservative management with ongoing surveillance was pursued. Conclusion This case illustrates the potential for advanced coarctation of the aorta to remain asymptomatic in elderly patients owing to compensatory vascular adaptation. It highlights the need for heightened clinical suspicion in patients with hypertension and individualized management strategies balancing risks of intervention against natural history.https://doi.org/10.1186/s13256-025-05282-3Aortic coarctationCongenital heart diseaseVascular dilationMortality ratesCase report
spellingShingle Zhiwei Zhong
Weimin Zhou
Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report
Journal of Medical Case Reports
Aortic coarctation
Congenital heart disease
Vascular dilation
Mortality rates
Case report
title Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report
title_full Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report
title_fullStr Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report
title_full_unstemmed Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report
title_short Extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta: a case report
title_sort extreme compensatory dilatation of the splanchnic artery caused by congenital coarctation of the abdominal aorta a case report
topic Aortic coarctation
Congenital heart disease
Vascular dilation
Mortality rates
Case report
url https://doi.org/10.1186/s13256-025-05282-3
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AT weiminzhou extremecompensatorydilatationofthesplanchnicarterycausedbycongenitalcoarctationoftheabdominalaortaacasereport