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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case is reported in which the patient had classic findings of an abdominal aortic aneurysm, including a pulsatile abdominal mass, curvilinear aortic calcification, and anterolateral deviation of the left ureter. These findings were subsequently demonstrated at surgery to be due to metastatic nodes from prostatic carcinoma. Data presented indicate that further diagnostic studies may be in order in unusual cases in which patients are suspected of having abdominal aortic aneurysm. This is especially true if the patient is known to have another condition such as carcinoma which may mimic aneurysm with metastatic periaortic lymph nodes. Aortography and/or lymphangiography occasionally have their place in selected patients, and this is discussed.
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PMID:Metastatic carcinoma of prostate masquerading as abdominal aortic aneurysm. 113 94

A 66-year-old man with the chief complaint of oliguria had been referred to our hospital under the diagnosis of bilateral hydronephrosis and abdominal aortic aneurysm by his family doctor. CT scan and digital subtraction angiography demonstrated an abdominal aortic aneurysm continuing to bilateral internal iliac arteries. The degree of right hydronephrosis was less advanced compared to the left side. Right percutaneous nephrostomy was performed because the retrograde stenting was unsuccessful. After the renal function improved, an operation for the aneurysm was undertaken in the surgical department. Although bilateral ureterolysis was possible, the resection of the aneurysm could not be done. After clamping the nephrostomy catheter, drainage of urine into the ureter was not seen one month after the operation. A double-J ureteral stent was inserted by the antegrade approach and the nephrostomy tube was removed. By exchanging the stent every 3 months, the renal function has been stable and the size of the aneurysm unchanged during the 25 months after the surgery.
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PMID:[Bilateral ureteral obstruction secondary to aneurysm of abdominal aorta: a case report]. 160 68

The horseshoe kidney is a rare anomaly that can significantly complicate aortic surgery. A bulky isthmus, abnormalities of renal anatomy, and a variable blood supply associated with a horseshoe kidney can pose technical difficulties in terms of aortic reconstruction. The left retroperitoneal approach affords an excellent exposure of the abdominal aorta in patients with a horseshoe kidney without dividing the renal isthmus and avoids the risk of injury to a ureter in an anomalous location. This is a case report of a patient with a horseshoe kidney who underwent a successful repair of an abdominal aortic aneurysm by a left retroperitoneal approach.
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PMID:The retroperitoneal approach to aortic surgery associated with horseshoe kidney. 175 95

Aortic repair by graft replacement is currently the most generally accepted and widely used technique in the treatment of infrarenal abdominal aortic aneurysm. Many alternative approaches have been considered in order to limit the physiological stress of surgery. A recently described technique involves an extraperitoneal approach to the abdominal aorta, whereby the aneurysm is left in situ, excluded from arterial pressure, and an infrarenal aortic bypass is performed. In this case report, this exclusion bypass technique was safely applied through a transperitoneal approach to manage a very large, tortuous and displaced infrarenal abdominal aortic aneurysm which was densely adherent to the left kidney and ureter.
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PMID:Exclusion bypass of a difficult abdominal aortic aneurysm. 199 91

Inflammatory aneurysms of the abdominal aorta (IAAAs) have distinctive clinical and physical characteristics that separate them from typical atherosclerotic aneurysms. They were identified in 19 (7.2%) of 265 patients undergoing abdominal aortic aneurysm repair. Symptoms were present in 12 (63%) of 19, with one patient presenting with rupture, and multiple symptoms were present in six (32%). Intraoperatively, all aneurysms exhibited dense periaortic inflammation. Adjacent structures most frequently involved were the duodenum in 15 (79%) of 19 patients, the left renal vein in six (32%) of 19, and the ureter in five (26%) of 19. Seventeen (94%) of the 18 patients who underwent elective aneurysm resection survived. The involvement of retroperitoneal structures varied in number and severity, demonstrating that a wide spectrum of inflammation is present in IAAAs, making diagnosis and definition difficult.
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PMID:Inflammatory aneurysms of the abdominal aorta. 273 Mar 17

The records of 16 patients with 44 aneurysms of the iliac artery during a 12-year period (1981 to 1992) were retrospectively reviewed. The mean age was 71.2 (range 53-81) years; the male/female ratio was 7:1. An extremely high incidence of isolated iliac artery aneurysm was noted relative to abdominal aortic aneurysm (11.7%) during the same period. Aneurysms ranged in size from 2 to 12 cm. Rupture occurred in four patients (25%). Six patients presented urologic complications of ureteral stenosis, with hydronephrosis caused by perianeurysmal fibrosis in five. Thirteen patients underwent surgical treatment with emergency operation performed in four with rupture and one with impending rupture. The mortality rate for ruptured aneurysm was high (50%). The operative procedures for common iliac aneurysms were open resection in 18, aneurysmectomy in two, and thromboexclusion in three. For internal iliac aneurysms, the procedures were aneurysmorrhaphy (partial resection) in five, obliterative endoaneurysmorrhaphy in seven, aneurysmectomy in two, and thromboexclusion in two, with appropriate graft replacement. Endarterectomy and reimplantation of the inferior mesenteric artery, and internal iliac artery graft interposition were performed to prevent colon ischaemia in three and two patients, respectively. Ureterolysis was performed in three patients with ureteral stenosis caused by perianeurysmal fibrosis, which improved hydronephrosis and renal function in two. Early diagnosis and elective surgery before rupture is the treatment of choice for saving the patient's life. The importance of preventing colon ischaemia for bilateral internal iliac aneurysms and ureterolysis for ureter entrapped within perianeurysmal fibrosis is emphasized.
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PMID:Isolated iliac artery aneurysm and its management. 795 55

We report a patient who developed a fistula between the right ureter and the right common iliac artery aneurysm. He had had replacement of a synthetic graft for abdominal aortic aneurysm sixteen years previously. The diagnosis was confirmed by angiography, retrograde pyelography and computed tomography. The fistula was treated by right nephroureterectomy and resection of right common iliac artery aneurysm. A brief description of the case is provided and the review of the literature is described.
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PMID:[Fistula between iliac artery aneurysm and ureter: a case report and review of the literature]. 828 65

This report describes the surgical management of 24 patients with concurrent abdominal aortic aneurysm (AAA) and urinary tract neoplasm. The patient population consisted of 22 men and two women whose average age was 65.5 years. AAA sizes ranged from 3.1 to 9.0 cm (mean 5.2 cm) in diameter. Urinary tract neoplasms included transitional cell carcinoma (TCC) of the bladder (n = 19), adenocarcinoma of the prostate (n = 3), and TCC of the renal pelvis (n = 2). Urologic procedures included radical prostatectomy, radical nephroureterectomy, and radical cystoprostatectomy with continent or ileal loop urinary diversion. The AAA was resected at the time of the urologic procedure in 12 patients (group I) or prior to the urologic procedure in five patients (group II) and was left in situ in seven patients (group III: AAA diameter 3.1 to 5.5 cm). All patients but one in group I recovered without complications. One patient developed an infection postoperatively as a result of fluid collection anterior to the aortic vascular graft; the fluid was successfully drained and the patient subsequently recovered uneventfully. All patients in group II had a marked retroperitoneal desmoplastic reaction at the time of the urologic procedure as a result of prior aneurysmectomy, which complicated the ureteral dissection. One patient later required an ileal ureteral reconstruction for obliterative fibrosis of the ureter. At a mean follow-up of 34 months, no infectious or mechanical complications of the vascular prosthesis occurred in group I or II. Eight patients in group I and two in group II are alive. Three have died of metastatic disease and two of myocardial infarction. Of the seven patients in group III, four subsequently required AAA resection for an increase in AAA size and three have died.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Concurrent abdominal aortic aneurysm and urologic neoplasm: an argument for simultaneous intervention. 854 Nov 90

The aneurysms of the internal iliac artery are rare and very often asymptomatic. Because of the anatomic location of this artery, it can be difficult to diagnose this kind of aneurysm, when isolated. Frequently it is diagnosed in consequence of aneurysmatic complication, such as rupture and/or impending rupture. In this work we report our experience concerning 6 cases of ruptured aneurysm of the internal iliac artery, observed in 5 patients. In three of these cases the lesion was isolated. In two cases the patients had already been operated on for abdominal aortic aneurysm, 4 and 6 years before. All the five patients were operated on. In 5 cases we ligated the aneurysm, without using any vascular graft. In one case where the external iliac artery was involved, we used a vascular graft between the common iliac and common femoral artery, in order to repair the vascular axis. One case of mortality was observed and a rare complication occurred in one case. An 83-year-old man treated in emergency for ruptured aneurysm of the left internal iliac artery, with regular post-operative course, was hospitalized again 24 days later with sepsis and pain in the left lower abdomen. A CT scan and a following urography showed a urinary fistula probably due to an ischemic necrosis of a segment of the ureter. A percutaneous nephrostomy has been performed and the patient successfully discharged.
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PMID:Ruptured aneurysm of the internal iliac artery. 886 73

In this case report inflammatory abdominal aortic aneurysm (IAAA) was superimposed on an arteriomegaly condition complicated by bilateral aneurysm of the common iliac arteries. Obstruction of the right ureter, mild hydronephrosis of the left system and a slight impairment of renal function were also present. Preoperative cellular and humoral immunological parameters were within normal limits while the erythrocyte sedimentation rate (ESR) was elevated (74 mm). Histological analysis showed numerous scattered lymphoid cells or organized in follicles with germinal centers within the adventitial thickening of the IAAA wall. Immunohistochemical analysis on frozen sections demonstrated that dispersed and perivascular lymphoid cells were mainly composed of similar amounts of CD3+/CD4+ and CD3+/CD8+ T lymphocytes. Histological analysis of the common iliac artery aneurysm showed a mild intimal thickening will small aggregates of macrophages. After aneurysm repair all peripheral blood analysis normalized within one month after surgery. The IAAA observed in our patient with arteriomegaly as underlying arterial disease cannot be interpreted as an inflammatory variation of an atherosclerotic aneurysm. The histological pattern of the inflammatory reaction and its resolution after surgery give, in our opinion, more credit to the etiopathogenetic hypothesis of a reaction elicited by an antigen within the arterial wall of the infrarenal aorta which might be enhanced by the lymphatic stasis subsequent to aneurysm compression.
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PMID:Arteriomegaly and inflammatory abdominal aortic aneurysm. Case report. 912 20


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