J Korean Med Sci.  2004 Apr;19(2):309-310. 10.3346/jkms.2004.19.2.309.

Experience of an Abdominal Aortic Aneurysm in a Patient Having Crossed Ectopia with Fusion Anomaly of the Kidney

• Kwon TW
• Sung KB
• Kim GE

• KMID: 1733497
• DOI: http://doi.org/10.3346/jkms.2004.19.2.309

Abstract

We report a case of surgically treated abdominal aortic aneurysm (AAA) in a patient having crossed ectopia with fusion anomaly of the kidney. One artery from the abdominal aorta above the aneurysm supplies the right kidney while three renal arteries (two from the aneurysm itself and one from the left common iliac artery) supply the crossed ectopic kidney. Preoperative imaging to define the arterial and collecting systems along with a detailed planning of the operation is essential to prevent ischemic renal injury as well as ureteral injury during AAA repair.

Keyword

Aortic Aneurysm; Abdominal; Renal Ectopia; Abnormrlities

MeSH Terms

Aged
Aortic Aneurysm, Abdominal/*complications/pathology/*surgery
Choristoma/*complications/pathology
Human
*Kidney
Kidney Diseases/*complications/pathology
Magnetic Resonance Angiography
Male

Figure

• 

  Fig. 1 Transfemoral aortogram shows one renal artery from the abdominal aorta for the upper (right) kidney, and two renal arteries from the aneurysm and 1 renal artery from the left common iliac artery for the lower kidney (crossover left). (white arrows: renal arteries).

• 

  Fig. 2 Postoperative MR angiogram shows patent renal arteries. During operation, we dissected the lower 2 renal arteries (1 from the aneurysm itself, 1 from the left common iliac artery) and anastomosed the lowest renal artery (from the left common iliac artery) to middle renal artery (from the aneurysm itself) in a side-to-end fashion before aneurysm resection. (white arrows: renal arteries).

Reference

1. Water HJ, Gaspar MR. Abdominal aortic and multiple iliac aneurysms associated with crossed-fused ectopia of the kidney: A case report and review. J Vasc Surg. 1988. 8:172–176.

2. Crawford ES, Coselli JS, Safi HJ, Martin TD, Pool JL. The impact of renal fusion and ectopia on aortic surgery. J Vasc Surg. 1988. 8:375–383.

3. 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 Vasc Surg. 1993. 17:940–947.

4. Graves FT. The arterial anatomy of the congenitally abnormal kidney. Br J Surg. 1969. 56:533–541.

5. Allen BT, Anderson CB, Rubin BG, Flye M, Baumann DS, Sicard GA. Preservation of renal function in juxtarenal and suprarenal abdominal aortic aneurysm repair. J Vasc Surg. 1993. 17:948–958.