Repair of superior mesenteric artery ligation during left nephrectomy with a native renal vein patch.
Injury to the superior mesenteric artery (SMA) during nephrectomy is a rare but potentially catastrophic complication. SMA injury during nephrectomy most commonly occurs with large tumors or bulky lymphadenopathy, with inadvertent injury or mistaken ligation of the SMA instead of the renal artery. Failure to recognize and repair an SMA injury results in ischemic bowel and death for most patients. We report a case of SMA ligation during left nephrectomy for xanthogranulomatous pyelonephritis, review the intraoperative evaluation of suspected SMA injury, and describe our vascular repair using a vein patch from the native left renal vein.
Blunt
Lynn W
LW
Department ofUrology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Matsumura
Jon
J
Carter
Michael F
MF
Gonzalez
Chris M
CM
Smith
Norm D
ND
D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D004927:Escherichia coli Infections / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008026:Ligation; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D009392:Nephrectomy; D009767:Obesity, Morbid / Q000150:complications; D011705:Pyelonephritis, Xanthogranulomatous / Q000150:complications / Q000601:surgery; D012082:Renal Veins / Q000637:transplantation*; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D014182:Transplantation, Autologous; D014463:Ultrasonography