Al-Juhani Abdulkreem, Khoja Sultan, Abdullah Abdullah, Desoky Rodan
General Surgery, King Abdulaziz University, Faculty of Medicine, Jeddah, SAU.
Vascular Surgery, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2025 Jul 7;17(7):e87428. doi: 10.7759/cureus.87428. eCollection 2025 Jul.
Repair of an abdominal aortic aneurysm (AAA) becomes significantly more complex when complicated by the presence of atypical renal vasculature and an ectopic kidney, as these anatomic variations pose distinct surgical challenges. In these cases, the surgeon must not only address the aneurysmal part of the aorta but also manage the aberrant renal anatomy to ensure the preservation of kidney function. This is critical in open AAA repair, where prolonged aortic clamping and manipulation near aberrant renal vessels can compromise renal perfusion. Preservation of renal function under these circumstances is technically demanding but essential for a successful outcome. This case report presents a 59-year-old male patient with an infrarenal abdominal aortic aneurysm and a pelvic ectopic kidney, in which the renal artery originated anomalously from the distal aorta. The patient underwent successful open surgical repair with a comprehensive planning and intraoperative strategy tailored to protect renal function while treating the aneurysm, emphasizing the importance of individualized surgical approaches in managing such rare and anatomically complex presentations.
当腹主动脉瘤（AAA）合并非典型肾血管系统和异位肾时，修复会变得显著更加复杂，因为这些解剖变异带来了独特的手术挑战。在这些情况下，外科医生不仅必须处理主动脉的动脉瘤部分，还必须处理异常的肾脏解剖结构，以确保肾功能的保留。这在开放性AAA修复中至关重要，因为在异常肾血管附近延长主动脉钳夹和操作会损害肾灌注。在这种情况下保留肾功能技术要求很高，但对成功的结果至关重要。本病例报告介绍了一名59岁男性患者，患有肾下腹主动脉瘤和盆腔异位肾，其肾动脉异常起源于主动脉远端。该患者通过全面规划和术中策略成功接受了开放性手术修复，该策略旨在在治疗动脉瘤的同时保护肾功能，强调了个体化手术方法在处理此类罕见且解剖结构复杂的病例中的重要性。
