A 91-year-old female presented with a pulsatile abdominal mass. Her past medical history included hypertension and hyperlipidemia. A 6.9 cm infrarenal abdominal aortic aneurysm, with a left ectopic pelvic kidney and t...A 91-year-old female presented with a pulsatile abdominal mass. Her past medical history included hypertension and hyperlipidemia. A 6.9 cm infrarenal abdominal aortic aneurysm, with a left ectopic pelvic kidney and two aberrant renal arteries, one each from the left and right common iliac arteries was found on computed tomography. Because of the high risk of rupture, surgery was recommended and an endovascular aneurysm repair was performed. The antegrade flow of the aberrant renal artery from the left common iliac artery was preserved. The right aberrant renal artery was covered with stent graft. The patient’s serum creatinine level remained unchanged throughout the postoperative course, with an uneventful postoperative recovery.展开更多
BACKGROUND Multiple renal artery aneurysms (RAAs) involving multiple branches in a solitary kidney are rare and present a major challenge to surgeons.Ex vivo or in situ repair combined with renal artery revascularizat...BACKGROUND Multiple renal artery aneurysms (RAAs) involving multiple branches in a solitary kidney are rare and present a major challenge to surgeons.Ex vivo or in situ repair combined with renal artery revascularization is the classical procedure for these complicated cases,which are not suitable for endovascular repair.The choice of bypass graft remains controversial because of the risk of aneurysmal degeneration for autologous graft.CASE SUMMARY A 39-year-old female patient presented with left lumbar pain for more than 3 mo.Computed tomography angiography showed congenital absence of the right kidney and three left RAAs involving multiple distal branches.This patient met the criteria for surgical repair due to symptoms of threatened rupture.According to the anatomy and location of multiple RAAs,ex vivo revascularization with saphenous vein graft (SVG) was performed.At the 3-year follow-up,computed tomography angiography demonstrated the aneurysmal degeneration of the Yshaped SVG.The patient remained asymptomatic and follow-up ultrasound showed no continuous growth of SVG aneurysm.CONCLUSION SVG aneurysm in RAA revascularization causes us to reflect on the choice of graft,especially for solitary kidney patients.展开更多
A renal paratransplant hernia is an unusual and potentially serious variant of an internal hernia. It is caused by entrapment of bowel through a defect in the peritoneum adjacent to the transplanted kidney. Abdominal ...A renal paratransplant hernia is an unusual and potentially serious variant of an internal hernia. It is caused by entrapment of bowel through a defect in the peritoneum adjacent to the transplanted kidney. Abdominal pain and vomiting with or without distention are the main symptoms. Prompt diagnosis and early surgical intervention are critical to prevent serious morbidity and even mortality. Historically, renal paratransplant hernias were repaired via an exploratory laparotomy. We present our experience in two patients with renal paratransplant hernia who were treated with laparoscopic repair.展开更多
文摘A 91-year-old female presented with a pulsatile abdominal mass. Her past medical history included hypertension and hyperlipidemia. A 6.9 cm infrarenal abdominal aortic aneurysm, with a left ectopic pelvic kidney and two aberrant renal arteries, one each from the left and right common iliac arteries was found on computed tomography. Because of the high risk of rupture, surgery was recommended and an endovascular aneurysm repair was performed. The antegrade flow of the aberrant renal artery from the left common iliac artery was preserved. The right aberrant renal artery was covered with stent graft. The patient’s serum creatinine level remained unchanged throughout the postoperative course, with an uneventful postoperative recovery.
文摘BACKGROUND Multiple renal artery aneurysms (RAAs) involving multiple branches in a solitary kidney are rare and present a major challenge to surgeons.Ex vivo or in situ repair combined with renal artery revascularization is the classical procedure for these complicated cases,which are not suitable for endovascular repair.The choice of bypass graft remains controversial because of the risk of aneurysmal degeneration for autologous graft.CASE SUMMARY A 39-year-old female patient presented with left lumbar pain for more than 3 mo.Computed tomography angiography showed congenital absence of the right kidney and three left RAAs involving multiple distal branches.This patient met the criteria for surgical repair due to symptoms of threatened rupture.According to the anatomy and location of multiple RAAs,ex vivo revascularization with saphenous vein graft (SVG) was performed.At the 3-year follow-up,computed tomography angiography demonstrated the aneurysmal degeneration of the Yshaped SVG.The patient remained asymptomatic and follow-up ultrasound showed no continuous growth of SVG aneurysm.CONCLUSION SVG aneurysm in RAA revascularization causes us to reflect on the choice of graft,especially for solitary kidney patients.
文摘A renal paratransplant hernia is an unusual and potentially serious variant of an internal hernia. It is caused by entrapment of bowel through a defect in the peritoneum adjacent to the transplanted kidney. Abdominal pain and vomiting with or without distention are the main symptoms. Prompt diagnosis and early surgical intervention are critical to prevent serious morbidity and even mortality. Historically, renal paratransplant hernias were repaired via an exploratory laparotomy. We present our experience in two patients with renal paratransplant hernia who were treated with laparoscopic repair.
