O'Dell Jordyn, Minc Samantha D, Ost Michael C, Grammer Robert, Markovich Brian, Pillai Lakshmikumar
West Virginia University School of Medicine.
West Virginia University, WVU Heart and Vascular Institute, Department of Cardiovascular and Thoracic Surgery.
Ann Vasc Surg Brief Rep Innov. 2024 Dec;4(4). doi: 10.1016/j.avsurg.2024.100336. Epub 2024 Sep 18.
There are a limited number of case reports describing the division of a horseshoe kidney (HSK) during trans- peritoneal repair of an abdominal aortic aneurysm (AAA). We present case of a juxta-renal AAA overlaid by an L shaped HSK, repaired trans- peritoneal with division of the isthmus. This was complicated by post-operative urinoma which was successfully treated interventionally. This approach was chosen due to the presence of the juxta-renal AAA with the majority of the HSK being perfused by a large left renal artery originating at the neck of the AAA. Temporary bilateral ureteral stents were placed. The isthmus of the HSK was divided followed by open tube graft repair of the AAA. Postoperative workup revealed an abdominal urinoma, which was successfully treated by urinary diversion and selective renal arterial branch embolization. Two years later, patient remains well with no evidence of hydronephrosis or graft infection.
仅有少数病例报告描述了在经腹主动脉瘤（AAA）修复术中对马蹄肾（HSK）进行分割的情况。我们报告了一例肾旁AAA合并L形HSK的病例，经腹手术修复，同时分割峡部。术后出现尿囊肿，经介入治疗成功治愈。选择这种方法是因为存在肾旁AAA，且大部分HSK由起源于AAA颈部的粗大左肾动脉供血。放置了临时双侧输尿管支架。分割HSK的峡部，然后开放管状移植物修复AAA。术后检查发现腹部尿囊肿，通过尿液改道和选择性肾动脉分支栓塞成功治疗。两年后，患者情况良好，无肾盂积水或移植物感染迹象。
