Idiopathic abdominal aortic dissection causing aortoiliac occlusive disease in a teenage boy

Abdominal aortic dissection (AAD) is very rare in the pediatric population in the absence of trauma, connective tissue disease, or infection. Our patient presented with an AAD causing aortoiliac occlusive disease (AIOD) and left popliteal arterial disease which is not described in the pediatric population. Presentation of the AIOD was classic in our pediatric patient though a distracting history of strained calf muscle during a sporting event delayed diagnosis by several months. Once the diagnosis was established, the interesting problem of managing this disease was met with possible risks of other vascular disease or even other organ disease. Further imaging and a genetic evaluation did not elucidate an etiology for our patient, only a suspicion. Post-surgical intervention was met with symptom resolution but warranted careful surveillance and follow-up in clinic by both genetics and vascular surgery.