Capone Amedeo, Fargion Aaron Thomas, Esposito Davide, Calugi Gianmarco, Innocenti Alessandro Alessi, Dorigo Walter, Pratesi Carlo, Pulli Raffaele
Department of Vascular Surgery, Careggi University Hospital, Florence, FI 50134, Italy.
J Surg Case Rep. 2023 Feb 22;2023(2):rjad053. doi: 10.1093/jscr/rjad053. eCollection 2023 Feb.
We report a case of a man with an Aorto-Iliac aneurysm and a congenital solitary pelvic kidney (CSPK). The maximum diameter of the aneurysm was 58 mm and the pelvic kidney was perfused by a single renal artery originating from the aortic bifurcation. A computed tomography scan was used for pre-operative planning and the patient underwent aorto-iliac aneurysm replacement with a Dacron graft. The renal artery was reimplanted on the Dacron right limb with a 'Carrel patch'. Several strategies were adopted to prevent renal ischemia such as sequential aortic cross clamping, selective cold perfusion of renal artery and a temporary Pruitt-Inahara shunt. The post-operative course was characterized by a transient increase in serum creatinine that did not require treatments and the patient was discharged after seven days. Congenital anomalies such as CSPK represent a challenge for the surgeon; however, the adoption of different intraoperative available strategies allowed to reduce possible complications.
我们报告一例患有主-髂动脉瘤和先天性孤立盆腔肾(CSPK)的男性病例。动脉瘤的最大直径为58毫米,盆腔肾由一条起源于主动脉分叉的单一肾动脉供血。术前通过计算机断层扫描进行规划,患者接受了用涤纶人工血管置换主-髂动脉瘤的手术。肾动脉通过“卡雷尔补片”重新植入涤纶人工血管的右支。为预防肾缺血采取了多种策略,如序贯性主动脉交叉阻断、肾动脉选择性冷灌注和临时普鲁伊特-稻原分流。术后病程的特点是血清肌酐短暂升高,但无需治疗,患者在七天后出院。像CSPK这样的先天性异常对外科医生来说是一项挑战;然而,采用不同的术中可用策略可减少可能的并发症。