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Query: UMLS:C0162871 (abdominal aortic aneurysm)
8,664 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 93-year-old patient with a cardiac pacemaker and biochemical renal failure presented with back pain suspicious for dissection. We performed gadolinium-enhanced thoracoabdominal multidetector CT angiography using eight-channel multidetector CT. Uniform aortic enhancement of 140 HU was sufficient to exclude aortic dissection and defined an unruptured infrarenal abdominal aortic aneurysm.
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PMID:Gadolinium-enhanced multidetector CT angiography of the thoracoabdominal aorta. 1248 27

Renal transplant recipients are at increased risk of malignancy and infection. We present the case of a 72-year-old-man with recurrent bladder carcinoma, abdominal aortic aneurysm repair, and end-stage renal failure due to renovascular disease. He received a cadaveric renal allograft into his left iliac fossa, was given cyclosporin A, azathioprine, and prednisolone triple therapy immunosuppression, and had no rejection episodes. He presented four years post-transplantation with a two-year history of intermittent sweats and fevers. Previous episodes had been investigated with no firm diagnosis made. This time he had right iliac fossa pain of three weeks' duration. Examination revealed a tender mass. Investigations showed unchanged graft function, but elevated inflammatory indices. Ultrasonography and computed tomography detailed an infiltrating mass associated with the sigmoid colon, which colonoscopy failed to visualise. At laparotomy a 6-cm tumor was removed, with adherent sigmoid colon and bladder dome. Macroscopically the mass was an abscess, and microscopy found acute and chronic inflammatory giant cells and fibrillary masses suggestive of actinomycosis, with no malignancy. The patient recovered uneventfully on antibiotics. At six months' follow-up, examination, inflammatory markers, and radiographic imaging showed no evidence of recurrence. Twelve months later the patient died of rupture of his proximal abdominal aorta. There was no evidence of recurrence at postmortem examination. We conclude with a brief review of actinomycosis in transplant recipients.
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PMID:An unusual abdominal mass in a renal transplant recipient. 1253 66

Aorto-caval fistula (ACF) is a rare complication of abdominal aortic aneurysm. It occurs in 1-6% of cases. The classic diagnostic signs of an ACF (pulsatile abdominal mass with bruit and right ventricular failure) are present only in a half of the patients. The most common diagnostic imaging procedures like ultrasound and computed tomography often are not sufficient enough. This leads to the delay in diagnosis, which has a great impact on the results of operation. We report a case of a patient, who was treated before admission to the Clinic because of azotemia and oliguria suggesting renal failure.
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PMID:[Aorto-caval fistula as a results of abdominal aortic aneurysm rupture imitating acute renal insufficiency]. 1271 63

Genitourinary anomalies can present a formidable challenge to the vascular surgeon at abdominal aortic reconstruction. We saw a case of crossed renal ectopia without fusion, a rare anomaly, associated with abdominal aortic aneurysm. Because of risk for injury to the kidney during surgery, preoperative evaluation of this anomaly must include computed tomography, angiography, and intravenous pyelography. Preoperative placement of a ureteral catheter may prevent injury to the anomalous ureter. Renal failure of the ectopic kidney during aortic reconstruction can be a serious problem. We used in situ hypothermic perfusion with cold (4 degrees C) Ringer solution for renal protection, and reimplanted the aberrant renal artery. The postoperative course was good, without major complications. The procedure for renal preservation must be selected on the basis of anatomic findings. We review the literature and present the first case of crossed renal ectopia.
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PMID:Abdominal aortic aneurysm associated with crossed renal ectopia without fusion: case report and literature review. 1275 61

Paraplegia is rare after open repair of infrarenal abdominal aortic aneurysm, and only two cases have been reported after endovascular repair, both due to atheroembolism. Incidence of renal failure after endovascular repair of abdominal aortic aneurysm (EVAR) in patients with normal preoperative renal function is about 8.7%, but is much higher in those with preexisting renal impairment, possibly because of administration of nephrotoxic contrast media during EVAR. We report a case in which contrast medium-induced acute renal failure is believed to have led to delayed paraplegia after EVAR.
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PMID:Delayed paraplegia after endovascular repair of abdominal aortic aneurysm. 1276 83

In the case of coexisting abdominal aortic aneurysm (AAA) and liver/renal failure, the controversial issue is the timing of the AAA repair and the transplantation of the affected organs. The question is whether to repair the AAA first and perform the double transplantation at a later time, or to perform all three procedures in the same operative session. This patient was affected by hepatic/renal failure and had also developed AAA. We describe the operative strategies utilized to perform the cadaver donor and recipient operations in this setting. In our patient, a combined liver/kidney transplantation with simultaneous aneurysm repair using arterial allografts was successfully performed. In a patient affected by end-stage liver, kidney, and aneurysmatic disease, a simultaneous liver/kidney transplant and AAA repair may represent the safest and most efficient treatment solution.
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PMID:Simultaneous orthotopic liver and kidney transplant with repair of abdominal aortic aneurysm: operative timing. 1285 43

The successful endovascular exclusion of a ruptured 3-cm diameter atherosclerotic abdominal aortic aneurysm (AAA) in a high-risk patient with renal failure is reported. An 82-year-old man with chronic renal failure and other comorbidities was admitted for acute abdominal pain. Duplex scan and computed tomography showed a ruptured 3-cm diameter atherosclerotic AAA. As a consequence of the patient's high surgical risk combined with signs of rupture, despite the progressively decreasing renal function, an emergency exclusion of the AAA was performed by means of a bifurcated Excluder (W. L. Gore and Associates) endovascular graft. The procedure was performed by minimizing administration of iodinated contrast medium using a guidewire into the lowest renal artery as a marker of proximal deployment. Intravascular ultrasound was used to confirm correct deployment. The postoperative recovery was characterized by acute renal insufficiency and bowel ischemia, which were treated with ultrafiltration and medical therapy, respectively, with complete resolution.
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PMID:Small ruptured abdominal aortic aneurysm with renal failure: endovascular treatment--a case report. 1289 71

During endovascular abdominal aortic aneurysm repair, aneurysmal involvement of the common or internal iliac arteries occasionally necessitates elective occlusion of one or both internal iliac arteries. Although elective internal iliac artery occlusion is often well tolerated, it can result in complications such as buttock claudication or rest pain, impotence, and colon ischemia. We report a case of gluteal compartment syndrome following elective unilateral internal iliac artery embolization prior to endovascular abdominal aortic aneurysm repair. On the first postoperative day, the patient developed sciatic nerve palsy, rhabdomyolysis, and renal failure, which promptly resolved after emergent operative exploration of his left buttock and debridement of all grossly necrotic muscle. This case emphasizes the point that, although elective internal iliac artery interruption is usually benign, it can have serious and unexpected complications that necessitate expeditious treatment for complete recovery.
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PMID:Gluteal compartment syndrome following elective unilateral internal iliac artery embolization before endovascular abdominal aortic aneurysm repair. 1498 67

Acute occlusion of an abdominal aortic aneurysm is a rare phenomenon. Its possible complications include distal spasm followed by arterial thrombosis, ischemia of the distal limbs, distal embolization, acidosis, hyperkalemia, and the development of venous thrombosis of the lower limbs. Surgical correction is often complicated by cardiac decompensation, renal failure, fatal pulmonary embolism, and metabolic derangements related to toxins released from the revascularized limb. Unless contraindicated, immediate systemic heparinization must be undertaken when the diagnosis is first suspected. We present a case of sudden occlusion of an abdominal aortic aneurysm complicated by venous thrombosis involving both lower extremities. After undergoing surgical revascularization, the patient sustained massive fatal pulmonary emboli. Prophylactic interruption of the inferior vena cava may be indicated in patients who present with this complication of abdominal aortic aneurysm.
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PMID:Acute occlusion of an abdominal aortic aneurysm complicated by bilateral lower extremity venous thrombosis: A case report. 1521 31

Chronic periaortitis commonly involves the infrarenal portion of the abdominal aorta. Idiopathic retroperitoneal fibrosis, inflammatory abdominal aortic aneurysm and perianeurysmal retroperitoneal fibrosis are its various clinical presentations. They present as a non-specific systemic inflammatory disorder and may lead to ureteric obstruction and consequent renal failure. An exaggerated inflammatory response to advanced atherosclerosis has been thought to be the main pathogenetic process. Autoimmunity has also been proposed as a contributing factor. Contrast-enhanced CT scanning is the diagnostic test of choice. Steroids and immunosuppressive agents are successfully used in the treatment of idiopathic retroperitoneal fibrosis and selected cases of inflammatory abdominal aortic aneurysm, and surgery is used in others. Early diagnosis is important in order to reduce morbidity from complications such as renal failure and mortality from aortic rupture.
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PMID:Chronic periaortitis. 1578 29


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