Bilateral renal artery stenosis with abdominal aorta coarctation in a child with severe hypertension - A case report and review

This report describes the clinical course, diagnostic evaluation, and manag ement of a 12-year-old child with bilateral renal artery stenosis (RAS) and concurrent narrowing of the abdominal aorta. The child was presented with a 2-day history of headache, vomiting, seizures, and right hemiparesis with normal findings from fundoscopic examination. There were no clinical or la boratory features suggesting the etiology of hypertension, nor had there be en any diagnostic procedures in screening for hypertension due to bilateral RAS. Abdominal aortography confirmed the diagnosis of bilateral RAS and ab dominal aorta coarctation. The hypertension was severe and resistant to com bination of several antihypertensive agents. Aortobilateral renal bypass wi th autogenous saphenous grafts and midaortic angioplasty with polytetrafluo roethylene (PTFE) was performed. Histopathologic studies revealed subintima l fibrosis.