Karpenko A A, Starodubtsev V B, Edemskiĭ A G, Cherniavskiĭ A M
Angiol Sosud Khir. 2011;17(2):139-44.
Presented herein are two clinical case reports concerning surgical management of posttraumatic arteriovenous aneurysms of the juxtarenal portion of the aorta and left renal vein, demonstrating the informative value of multispiral computed angiography in diagnosis of the pathology involved. Two patients presenting with a stab-and-lacerated wound of the abdominal cavity and subjected to comprehensive examination were found to have an arteriovenous anastomosis between the aorta and left renal vein with the formation of an up to 35-mm aneurysm in one case, and an arteriovenous anastomosis between the left renal artery and left renal vein with the formation of a pseudoaneurysm sized up to 30 mm in the other. Both patients had a clinical picture of cardiopulmonary insufficiency induced by overloading of the right portions of the heart. Both pathologies were treated surgically in the scope of removing the arteriovenous anastomosis and aneurysm of the juxtarenal portion of the abdominal aorta and left renal artery. The postoperative period showed nothing to report and turned out uneventful, with the patients being discharged from the clinic in a satisfactory condition with good laboratory and haemodynamic parameters.
本文介绍了两例关于主动脉肾旁段和左肾静脉创伤后动静脉瘤手术治疗的临床病例报告，展示了多排螺旋计算机血管造影在该病理诊断中的参考价值。两名因腹腔刺伤而接受全面检查的患者，其中一例发现主动脉与左肾静脉之间存在动静脉吻合，并形成了一个最大直径达35毫米的动脉瘤；另一例发现左肾动脉与左肾静脉之间存在动静脉吻合，并形成了一个最大直径达30毫米的假性动脉瘤。两名患者均有因右心负荷过重导致的心肺功能不全临床表现。两种病变均在手术中切除了腹主动脉和左肾动脉肾旁段的动静脉吻合及动脉瘤。术后恢复顺利，无异常情况报告，患者出院时情况良好，实验室检查和血流动力学参数均令人满意。
