title: Aortoiliac aneurysm with congenital right pelvic kidney.
abstract: The association of congenital pelvic kidney with abdominal aortoiliac aneurysm is an extremely rare clinical finding. Previous reports have described various methods of aneurysm repair with successful preservation of the function of pelvic kidney. However, to our knowledge, reconstruction of more than two renal arteries has not been established. We report a case of abdominal aortic aneurysm complicated by congenital right pelvic kidney in a 72-year-old man. Computed tomography (CT) revealed an abdominal aortic aneurysm with a maximum diameter of 54 mm and a right common iliac aneurysm of 45 mm. In addition, he had a congenital right pelvic kidney and CT angiography identified three right pelvic renal arteries. The upper artery originated from the bifurcation of the terminal aorta and the lower two originated from the right common iliac artery. Three-dimensional CT was helpful for the accurate planning of the operation. Open surgical repair of the aortoiliac aneurysm with a Dacron bifurcated graft replacement was decided and reimplantation of all three right pelvic kidney arteries to the right limb of the graft was also performed. For renal preservation, the right pelvic kidney arteries were perfused with cold Ringer's lactate using a rapid infusion pump and coronary perfusion cannula. The patient's postoperative course was uneventful, and worsening of renal function was not observed. The perfusion of renal arteries with cold Ringer's solution was thought to be a simple and appropriate procedure for renal protection.
authors: Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan, miracle5jp@yahoo.co.jp.
authors: Kazuma
authors: K
authors: Date
authors: Shuuichi
authors: S
authors: Okada
authors: Masahiko
authors: M
authors: Ezure
authors: Hitomi
authors: H
authors: Takihara
authors: Shuuichi
authors: S
authors: Okonogi
authors: Yutaka
authors: Y
authors: Hasegawa
authors: Yasushi
authors: Y
authors: Sato
authors: Tatsuo
authors: T
authors: Kaneko
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D021621:Imaging, Three-Dimensional; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging; D008297:Male; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012077:Renal Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D012092:Replantation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome