A case of abdominal aortic aneurysm accompanied by horseshoe kidney

At nalı böbrek anomalisi varlığında oluşan abdominal aort anevrizması oldukça nadir görülen bir tablodur. Çoğunlukla böbrek parenkim dokusundan oluşan istmus, anevrizmanın cerrahisi sırasında teknik zorluğa neden olmaktadır. Elli iki yaşında bir erkek hastada abdominal aort anevrizması ve at nalı böbrek saptandı. Karında açılan medyan kesiyi takiben transperitoneal yaklaşımla anevrizmanın eksplorasyonu yapıldı. Anevrizmanın her iki iliyak arteri tuttuğu görüldü. Her iki böbreğin alt polleri anevrizmayı örten kalın bir istmus ile bağlantılıydı. Anevrizma kesesini açmaksızın, anevrizma, her iki iliyak arterin proksimal kısımlarına uzanan Dacron yama ile sarıldı. Ameliyat sırasında ve ameliyat sonrası dönemde komplikasyon olmadı. On ay sonra, hastanın asemptomatik olduğu ve normal günlük işlerini yapabildiği görüldü.

At nalı böbreğe eşlik eden abdominal aort anevrizması: Olgu sunumu

Abdominal aortic aneurysm in the presence of horseshoe kidney is a very rare clinical entity. The connecting tissue is usually formed by a functional renal parenchyma, causing technical difficulties during surgery. An abdominal aortic aneurysm and horseshoe kidney was detected in a 52-year-old male patient. Following a median incision in the abdomen a transperitoneal approach was used to explore the aneurysm, which was noted to involve both iliac arteries. The lower poles of both kidneys were connected with a thick isthmus overlying the aneurysm. The aneurysm was wrapped with a Dacron patch extending to the proximal segments of both iliac arteries, without opening the sac. There was no complication during the operation or in the postoperative period. After 10 months, he was asymptomatic and enjoying normal daily activities.

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1. B auer SB, Perlmutter AD, Retik AB. Anomalies of the uppe1 urinary tract. In: Walsh PC, Retik AB, Starney DA, Vaughan ED Jr, Weih AJ, editors. Campbell's urology. Vol. 2, 6th ed. Philadelphia: W. B. Saunders; 1992. p. 1376-81.
2. Graves FT. The arterial anatomy of the congenitally abnormal kidney. Br J Surg 1969;56:533-41.
3. Stroosma OB, Kootstra G, Schurink GW. Management of aortic aneurysm in the presence of a horseshoe kidney. Br J Surg 2001;88:500-9.
4. Kolin CP, Boatman DL, Schmidt JD, Flocks RH. Horseshoe kidney: a review of 105 patients. J Urol 1972; 107:203-4.
5. Shortell CK, Welch EL, Ouriel K, Green RM, DeWeese JA. Operative management of coexistent aortic disease and horseshoe kidney. Ann Vase Surg 1995;9:123-8.
6. O'Hara PJ, Hakaim AG, Hertzer NR, Krajewski LP, Cox GS, Beven EG. Surgical management of aortic aneurysm and coexistent horseshoe kidney: review of a 31-year experience. J Vase Surg 1993; 17:940-7.
7. Canova G, Masini R, Santoro E, Bartolomeo S, Martini C, Becchi G. Surgical treatment of abdominal aortic aneurysm in association with horseshoe kidney. Three case reports and a review of technique. Tex Heart Inst J 1998; 25:206-10.
8. Louagie YA, Schoevaerdts JC, D'Udekem FD, Ponlot R. Horseshoe kidney and abdominal aortic aneurysm. Acta Chir Belg 1984;84:249-54.