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

Two cases of aorta-left renal vein fistula (ALRVF) resulting from abdominal aortic aneurysm (AAA) are reported. A review of the literature reveals only 10 other such cases. Clinical presentation included left flank pain in 75% of cases, hematuria in 92%, hypotension in 8%, a pulsatile mass in 58%, and an abdominal bruit in 75%. Intravenous pyelography was performed in 58% of cases and consistently showed decreased function of the left kidney. Arteriography was obtained in 58% of patients and was always diagnostic. Incidence, pathophysiology, and surgical management of this condition are discussed.
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PMID:Fistulas between the aorta and the left renal vein. 361 68

We report a case of aorto-left renal vein fistula secondary to an aortic aneurysm presenting with flank pain, a left-sided varicocoele and microscopic haematuria. These symptoms and signs should alert the clinician to this rare complication of abdominal aortic aneurysm.
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PMID:Rupture of an aortic aneurysm into the renal vein presenting as a left-sided varicocoele. Case report. 367 60

Anecdotal reports of chronic contained rupture of abdominal aortic aneurysms exist. Their existence and implications have been largely ignored. From March 1984 to March 1985, 24 patients required repair of an infrarenal abdominal aortic aneurysm. Four patients underwent emergent repair. The remaining 20 patients were evaluated with computed tomography electively. Seven patients (35%) were demonstrated to have a rupture of the aneurysm and a retroperitoneal hematoma on the computed tomographic scan. All of the patients had histories of back or flank pain; five patients continued to complain of mild pain on admission. In no case was shock, impending shock, or a decrease in the hemoglobin level present on admission. All patients were operated on within 24 hours of evaluation. At operation, rupture was noted with organized hematoma outside the aorta contained in a pseudoaneurysmal wall of retroperitoneal connective tissue. There was no intraperitoneal blood. There was no operative mortality and survival was 100% at six months. The CT scan evaluation had identified a subgroup of patients with aneurysms associated with chronic contained rupture.
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PMID:Chronic contained rupture of abdominal aortic aneurysms. 370 32

Spontaneous aorta-left renal vein fistula (ALRVF) caused by abdominal aortic aneurysm (AAA) is a rare form of intravascular aneurysm rupture. The literature series of ALRVF, updated here to 19 reported cases, demonstrates that patients with ALRVF present with a unique clinical syndrome characterized by abdominal or left flank pain (84%), a pulsatile abdominal mass (63%), abdominal bruit or murmur (63%), hematuria (100%), and nonfunction of the left kidney on functional imaging studies (100% of patients studied). Operative findings in ALRVF syndrome have included a large AAA (mean diameter 9.2 cm), with frank rupture in only three; in 17 of 19 patients (89%) the ALRVF was associated with a retroaortic left renal vein anomaly. The patient presented here had a large juxtarenal AAA with rupture into the left retroperitoneal space. The wide aneurysm neck and expanding hematoma created an avulsion of the second left lumbar vein from its junction with an anatomically normal (preaortic) left renal vein; the resulting renal vein tear allowed development of an arteriovenous communication that was responsible for the clinical presentation of ALRVF syndrome. The disease found here demonstrates a novel mechanism for the production of ALRVF syndrome in patients with juxtarenal AAA and otherwise normal pararenal venous anatomy.
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PMID:Aorta-left renal vein fistula syndrome caused by rupture of a juxtarenal abdominal aortic aneurysm: novel pathologic mechanism for a unique clinical entity. 835 Apr 42

The differential diagnosis of acute flank pain includes kidney stones, urinary tract infection, dissecting abdominal aortic aneurysm (AAA), arterial or venous compromise of the kidney, renal abscess, renal carcinoma, and papillary necrosis. This is a report of an unusual cause of renal colic: pyelocalyceal diverticulum. Stasis of urine within a diverticulum promotes both calculus formation and urinary tract infection, either of which can lead to colic. Several radiographic findings may suggest a calyceal diverticulum, including, on plain X-ray, a very peripheral or mobile renal calculus, or on intravenous pyelogram, an early filling-defect and delayed or retained filing of a circular or ovoid mass.
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PMID:Pyelocalyceal diverticulum: an unusual cause of acute renal colic. 1221 67

We report on a posterior "nutcracker" phenomenon due to an abdominal aortic aneurysm in a patient with a retro-aortic left renal vein. A 71-year-old man with a known abdominal aortic aneurysm presented in the emergency room with mild hematuria and flank pain. Computed tomography angiography revealed an aortic aneurysm, which compressed the left renal vein between the aorta and the vertebral column. Compression of the left renal vein, due to the aorta with consecutive congestion and hematuria as well as flank pain, was previously described as nutcracker phenomenon. In case of a retro-aortic left renal vein, increase of the aortic diameter can lead to compression of the renal vein and furthermore to the classical signs and symptoms of the "nutcracker" phenomenon, even though the aneurysm is not ruptured or there are no aorto-caval or aorto-left renal vein fistulas.
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PMID:Posterior "Nutcracker" phenomenon in a patient with abdominal aortic aneurysm. 1252 23

A 71-year-old man presented complaining of severe left flank pain. A computed tomography scan of the abdomen disclosed a left peripelvic extravasation of urine and a 4.0-cm abdominal aortic aneurysm with a significant amount of perianeurysmal thickening and prominent left hydroureter. The patient was diagnosed as having an inflammatory aneurysm of the abdominal aorta (IAAA) with peripelvic extravasations of urine. We report the results of a patient with IAAA with ureteral obstruction successfully treated with steroid therapy and a ureteral stent.
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PMID:Spontaneous peripelvic extravasation of urine due to an inflammatory aneurysm of the abdominal aorta. 1515 13

The classic presentation of acute renal colic is the sudden onset of very severe pain in the flank primarily caused by the acute ureteral obstruction. The diagnosis is often made on clinical symptoms only, although confirmatory exams are generally performed because many others significant disorders may present with symptom of flank pain that mimics renal colic. Life threatening emergency such as abdominal aortic aneurysm must be ruled out. While non contrast CT has become the standard imaging modality, in some situations, a plain abdominal radiograph associated with a renal ultrasound or a contrast study such as intravenous pyelogram may be preferred. Hematuria is frequently present on urine analysis. The usual therapy represented by analgesic and nonsteroidal anti-inflammatory drugs should be started as soon as possible. Size and location of the stone are the most important predictors of spontaneous passage. Uncontrolled pain by medical therapy, fever, oligo-anuria suggest complicated stone disease. Such conditions require emergency treatment by drainage or stone extraction. Although recurrent stone rate is important, extensive metabolic explorations are not recommended after an uncomplicated first episode. Nevertheless fluid intake is encouraged and a stone chemical analysis should be performed whenever possible.
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PMID:[Excruciating flank pain: "acute renal colic"]. 1518 32

Fistulas complicating an abdominal aortic aneurysm (AAA) are rare, and fistulas involving the left renal vein are particularly uncommon. We highlight here a fistula between an infrarenal aortic aneurysm and a retroaortic left renal vein, revealed by left flank pain associated with hematuria and acute renal failure. The multislice CT angiography performed in this 68-year-old patient revealed communication and equal enhancement between the aorta and the left gonadic vein, suggesting the presence of a fistula. The three-dimensional VRT reconstructions presented in this case were of great value in the preoperative planning, enabling immediate visualization of this unusual feature. Alternative diagnoses to consider when encountering this clinical presentation are reviewed.
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PMID:Aorta-left renal vein fistula complicating an aortic aneurysm: preoperative and postoperative multislice CT findings. 1703 29

The successful endovascular repair of a type III thoracoabdominal aortic aneurysm (TAAA) with the use of a tube endograft is reported. A 56-year-old male with a 6.4-cm type III TAAA, a 4.2-cm infrarenal abdominal aortic aneurysm, and chronic renal insufficiency presented with flank pain, nausea, acute anuria, and serum creatinine of 6.1 mg/dl. Acute occlusion of the left solitary renal artery was diagnosed and emergent recanalization with percutaneous transluminal angioplasty and stenting was performed successfully, with reversal of the serum creatinine level at 1.6 mg/dl. Further imaging studies for TAAA management revealed ostial occlusion of both the celiac artery (CA) and the superior mesenteric artery (SMA) but a hypertrophic inferior mesenteric artery (IMA) providing retrograde flow to the aforementioned vessels. This rare anatomic serendipity allowed us to repair the TAAA simply by using a two-component tube endograft without fenestrations (Zenith; William Cook, Bjaeverskov, Denmark) that covered the entire length of the aneurysm, including the CA and SMA origins, since a natural arterial bypass from the IMA to the CA and SMA already existed, affording protection from gastrointestinal ischemic complications. The patient had a fast and uneventful recovery and is currently doing well 6 months after the procedure. To our knowledge, this is the first report in the English literature of successful endovascular repair of a TAAA involving visceral arteries with the simple use of a tube endograft.
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PMID:Endovascular repair of a type III thoracoabdominal aortic aneurysm in a patient with occlusion of visceral arteries. 1745 Mar 97


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