%0 Journal Article
%T Bowel ischemia in a baby with unspecified renovascular hypertension: a case report
%A Omar Oda
%A Mohammad Zamakhshary
%A Mohammad Namshan
%A Saud Jadaan
%A Hisham Shalaan
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-569
%X We present the case of an 18-day-old Saudi girl with hypertension due to unspecified vascular occlusive disease. The hypertension was managed medically by maintaining blood pressure at 'near normal' levels, and this led to bowel ischemia. Our patient survived the short bowel syndrome and is now two years old. She is on full oral feeding and has reached acceptable growth parameters. Her blood pressure has stabilized at around 110/70 mmHg without anti-hypertensive drugs. She has good organ function and walks despite increased narrowing in stenotic areas and complete obliteration of her left iliac and femoral arteries as seen on follow-up computed tomography angiography.We suggest keeping blood pressure at the highest levels permissible in similar clinical situations to prevent a state of bowel hypoperfusion. When alternative treatments for congenital multiple visceral arterial stenoses are not feasible, careful medical therapy and a waiting approach for collaterals to develop may be appropriate.Renovascular disease is an important cause of hypertension in children, and the incidence is reported to be 3% to 10% [1-5]. Medical management remains the first line of treatment [1-9]. However, 'unwise' control of blood pressure (BP) may lead to disastrous situations. We present the case of a baby with congenital multiple visceral arterial stenoses in which medical therapy contributed to the development of bowel ischemia.An 18-day-old full-term Saudi girl who had an unremarkable prenatal and family history (as obtained from the parents) and who was born via normal spontaneous vaginal delivery with a birth weight of 2.5 kg was admitted to a provincial hospital with cardiogenic shock. High BP was diagnosed, and she was treated as a case of cardiomyopathy and was discharged home after 10 days on propranolol and captopril. Without a medical report from the previous hospital, her parents brought her to our pediatric emergency room at the age of 45 days with lethargy and poor oral
%U http://www.jmedicalcasereports.com/content/5/1/569