title: Rupture and bleeding secondary to renal infarction in a patient with an abdominal aortic aneurysm.
abstract: A 57-year-old man had been followed up for severe left ventricular dysfunction after acute myocardial infarction with a left ventricular thrombus. He had been treated with anticoagulant and antiplatelet therapy and was admitted to our hospital because of abdominal pain and shock. He had no prior episode of trauma. The electrocardiogram (ECG) showed no changes compared with the previous ECG. Enhanced abdominal computed tomography (CT) showed a retroperitoneal hematoma around an abdominal aortic aneurysm (AAA) and the right kidney. We suspected rupture of AAA or the right kidney, and we performed AAA replacement with a Y-shaped graft and nephrectomy of the right kidney. Pathological examination revealed hemorrhagic infarction of the lower part of the right kidney, with hemorrhage and rupture at the center of the infarct. In our case, enhanced CT showed extravasation from the lower part of the right kidney. In addition, postoperative echocardiography showed that the left ventricular thrombus had disappeared. We report a case of rupture and bleeding secondary to renal infarction in a patient with an AAA.
authors.affiliation: Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hiraoka
authors.forename: Shogo
authors.initials: S
authors.lastname: Mukai
authors.forename: Shogo
authors.initials: S
authors.lastname: Obata
authors.forename: Hironobu
authors.initials: H
authors.lastname: Morimoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Uchida
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Yamane
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D004562:Electrocardiography; D006331:Heart Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013927:Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome