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先天性孤立盆腔肾(CSPK)患者腹主动脉-髂动脉瘤的外科治疗:病例报告及文献复习

Surgical therapy of aorto-iliac aneurysm in a patient with congenital solitary pelvic kidney (CSPK): case report and literature review.

作者信息

Capone Amedeo, Fargion Aaron Thomas, Esposito Davide, Calugi Gianmarco, Innocenti Alessandro Alessi, Dorigo Walter, Pratesi Carlo, Pulli Raffaele

机构信息

Department of Vascular Surgery, Careggi University Hospital, Florence, FI 50134, Italy.

出版信息

J Surg Case Rep. 2023 Feb 22;2023(2):rjad053. doi: 10.1093/jscr/rjad053. eCollection 2023 Feb.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecc0/9946770/f8234f807665/rjad053f1.jpg

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