Makris Sotirios A, Kanellopoulos Eleftherios, Chronopoulos Anastasios, Vrachliotis Thomas G, Doundoulakis Nikolaos
Department of Vascular and Endovascular Surgery, Henry Dunant Hospital, 107 Mesogion Ave, Athens, 11526, Greece.
J Med Case Rep. 2011 Mar 6;5:92. doi: 10.1186/1752-1947-5-92.
Congenital solitary pelvic kidney is a rare condition, and its association with an abdominal aortic aneurysm is even more unusual. To the best of our knowledge, only two such cases have been reported in the literature to date.
We report the case of a 59-year-old Caucasian man with a congenital solitary pelvic kidney, who was found to have an abdominal aortic aneurysm 83 mm in diameter. Abdominal computed tomography angiography clearly identified two renal arteries, one originating from the aortic bifurcation. and the other from the proximal portion of the right common iliac artery. At surgery, renal ischaemia was prevented by introduction of an axillofemoral shunt (consisting of two femoral cannulas and a vent tube of extracorporeal circulation) from the right axillary to the right femoral artery, and a second Argyle shunt from the right common iliac artery to the origin of the left renal artery. A 20 mm Dacron tube graft was then implanted. Our patient's postoperative renal function was normal.
The renal preservation double shunt technique used in this case seems to be effective during abdominal aortic aneurysm repair.
先天性孤立盆腔肾是一种罕见病症，其与腹主动脉瘤相关联则更为罕见。据我们所知，迄今为止文献中仅报道过两例此类病例。
我们报告一例59岁的白种男性患者，患有先天性孤立盆腔肾，其腹主动脉瘤直径达83毫米。腹部计算机断层扫描血管造影清晰显示两条肾动脉，一条起源于主动脉分叉处，另一条起源于右髂总动脉近端。手术时，通过从右腋动脉至右股动脉置入腋股分流管（由两根股动脉插管和一根体外循环排气管组成）以及从右髂总动脉至左肾动脉起始处置入第二根阿盖尔分流管来防止肾缺血。随后植入一根20毫米的涤纶人工血管。我们的患者术后肾功能正常。
该病例中所采用的保留肾双分流技术在腹主动脉瘤修复术中似乎是有效的。
