Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report

Introduction. Horseshoe kidney (HSK) is a congenital anomaly of embryonic kidneys, which occurs in early gestation when both kidneys are in close proximity. This hap-pens as a result of abnormal migration of nephrogenic cells. The presence of HSK may complicate an anterior approach to reconstructive...

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Main Authors: Tomić Aleksandar, Marjanović Ivan, Sekulić Dragan
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900059T.pdf
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author Tomić Aleksandar
Marjanović Ivan
Sekulić Dragan
author_facet Tomić Aleksandar
Marjanović Ivan
Sekulić Dragan
author_sort Tomić Aleksandar
collection DOAJ
description Introduction. Horseshoe kidney (HSK) is a congenital anomaly of embryonic kidneys, which occurs in early gestation when both kidneys are in close proximity. This hap-pens as a result of abnormal migration of nephrogenic cells. The presence of HSK may complicate an anterior approach to reconstructive surgery of the aorta and iliac vessels because the isthmus of the HSK lies across the aorta. HSK is often associated with anomalous renal vessels. Case report. A 71-year-old female patient was admit-ted with an abdominal aortic aneurysm, 50 mm in diameter, and HSK, and multiple aberrant renal vessels with subocluded upper left renal artery as seen on the multidetector computed tomography (MDCT). Open surgical treatment was applied. Endarterectomy of the left upper renal artery, perfusion of the right common bottom pole renal artery, and reimplantation of both bottom polar renal arteries were done. Isthmus was not divided. The co-existence of HSK and abdominal aortic aneurysm (AAA) is a rare condition. It presents a technical challenge to vascular surgeons because the surgical treatment of such an aneurysm is complicated due to the abnormal anatomy, difficulties in exposing the aneurysm, and a variable blood supply to the isthmus and lower poles of the HSK. Conclusion. Open surgical repair of AAA with HSK is a successful method and provides good exposure, the possibility of renal circulation preservation, and prevention of renal insufficiency.
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spelling doaj-art-86e5aba39787451194eff35f61abab142025-08-20T01:58:30ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178226126410.2298/VSP190925059T0042-84501900059TAbdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case reportTomić Aleksandar0Marjanović Ivan1Sekulić Dragan2https://orcid.org/0000-0002-3128-4953Military Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Clinic for Vascular and Endovascular Surgery, Belgrade, SerbiaIntroduction. Horseshoe kidney (HSK) is a congenital anomaly of embryonic kidneys, which occurs in early gestation when both kidneys are in close proximity. This hap-pens as a result of abnormal migration of nephrogenic cells. The presence of HSK may complicate an anterior approach to reconstructive surgery of the aorta and iliac vessels because the isthmus of the HSK lies across the aorta. HSK is often associated with anomalous renal vessels. Case report. A 71-year-old female patient was admit-ted with an abdominal aortic aneurysm, 50 mm in diameter, and HSK, and multiple aberrant renal vessels with subocluded upper left renal artery as seen on the multidetector computed tomography (MDCT). Open surgical treatment was applied. Endarterectomy of the left upper renal artery, perfusion of the right common bottom pole renal artery, and reimplantation of both bottom polar renal arteries were done. Isthmus was not divided. The co-existence of HSK and abdominal aortic aneurysm (AAA) is a rare condition. It presents a technical challenge to vascular surgeons because the surgical treatment of such an aneurysm is complicated due to the abnormal anatomy, difficulties in exposing the aneurysm, and a variable blood supply to the isthmus and lower poles of the HSK. Conclusion. Open surgical repair of AAA with HSK is a successful method and provides good exposure, the possibility of renal circulation preservation, and prevention of renal insufficiency.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900059T.pdfabdominal aortic aneurysmhorseshoe kidneyendarterectomyreimplantationperfusion
spellingShingle Tomić Aleksandar
Marjanović Ivan
Sekulić Dragan
Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report
Vojnosanitetski Pregled
abdominal aortic aneurysm
horseshoe kidney
endarterectomy
reimplantation
perfusion
title Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report
title_full Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report
title_fullStr Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report
title_full_unstemmed Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report
title_short Abdominal aortic aneurysm and horseshoe kidney-open surgical repair: A case report
title_sort abdominal aortic aneurysm and horseshoe kidney open surgical repair a case report
topic abdominal aortic aneurysm
horseshoe kidney
endarterectomy
reimplantation
perfusion
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900059T.pdf
work_keys_str_mv AT tomicaleksandar abdominalaorticaneurysmandhorseshoekidneyopensurgicalrepairacasereport
AT marjanovicivan abdominalaorticaneurysmandhorseshoekidneyopensurgicalrepairacasereport
AT sekulicdragan abdominalaorticaneurysmandhorseshoekidneyopensurgicalrepairacasereport