Aortenaneurysma und Hufeisenniere ? Kasuistik und Literatur�bersicht

Schwilden, E.-D.; Barwegen, M. G. M. H.; Dongen, R. J. A. M. van

doi:10.1007/bf01261400

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…With optimal preoperative aortography and functional work-up (to assess the significance of renal artery stenosis, for instance), these pitfalls can be avoided. Progress in treatment includes intraluminal dilatation of the stenosed renal artery (4 cases in our series), reimplantation of an accessory renal vessel (one case in our series), and division of the parenchymal bridge of a horseshoe kidney [38].…”

Section: Ischemia Of the Left Colonmentioning

confidence: 94%

Pitfalls and progress in the management of abdominal aortic aneurysms

et al. 1988

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Based on a review of the literature and 241 cases of abdominal aortic aneurysm (AAA) operated at the Mannheim Surgical Clinic, the progress and pitfalls in the management of this lesion are discussed. Progress in diagnosis is based on noninvasive imaging procedures, e.g., ultrasound, which lead to the detection of more aneurysms before they rupture. Ultrasound also plays a role in the observation of small asymptomatic aneurysms in high‐risk patients, helping some to avoid operation as well as rupture. Progress in the treatment of AAA means simplification: rapid clamping of the aorta in case of rupture, minimal dissection, and aneurysmal repair with straight‐tube interposition by the inlay technique. The pitfalls of “trash foot,” colon, or renal ischemia as well as graft infection can be mostly circumvented by observance of technical detail. In this series, the mortality following repair of asymptomatic AAA was 3.7%; for symptomatic aneurysms, it was 8%; and for ruptured aneurysms, it amounted to 55%.

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Section: Ischemia Of the Left Colonmentioning

confidence: 94%

Pitfalls and progress in the management of abdominal aortic aneurysms

et al. 1988

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“…Nachdem Schwilden et al 1978 [12]. Beide Arten gehö ren entwicklungsgeschichtlich zu persistierenden Urnierenarterien.…”

Section: Morphologieunclassified

“…Die Indikation zur Operation ergibt sich allein aus der Pathologie des Gefä ßprozesses (Verschlußprozesse der Aorta, Aneurysmen). Eine konkomitierende HEN stellt heute keine Kontraindikation mehr dar, wie es in ausgewä hlten Fä llen noch vor einigen Jahren postuliert worden ist [20,21]. Auch die Transplantation einer HEN ist prinzipiell mö glich [16].…”

Section: Diskussionunclassified

“…Um das Leben des Patienten zu retten, kann in diesen Fä llen auch eine primä re Durchtrennung des Nierenisthmus erforderlich werden [21]. De Virgilio et al (1995) wiesen in ihrem Krankengut ohne Angabe der Operationsdringlichkeit eine Komplikationsrate von 29 % aus [28].…”

Section: Diskussionunclassified

“…Wä hrend Connelli et al 1980 ü ber 56 Fä lle der Weltliteratur berichteten, kann heute von ü ber 200 Operationen allein im europäi-schen Raum ausgegangen werden [5,21]. Die Hä ufigkeit der Kombination HEN und BAA wird mit 1 : 120-200 (0,5-0,8 %) angegeben [4].…”

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Aortenaneurysma bei Hufeisenniere – Spezielle Diagnostik und Therapie

Luther

Sandmann

Reiher

et al. 1997

Chirurg

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The co-existence of horseshoe kidney (HSK) and abdominal aortic aneurysm (AAA) is rare and demands a special diagnostic workup and a meticulous surgical procedure. Ten patients with HSK associated with AAA are reported. All underwent aortic replacement with successful preservation of multiple renal arteries. One patient died at the 7th postoperative day from myocardial infarction. HSK does not represent a contraindication for aortic repair. Angiography for identification of aberrant renal arteries and classification into three types for surgical management is mandatory. In type I and II we recommend a standard midline transperitoneal approach. Only in type III does a thoraco-abdominal approach seem favourable. The aortic reconstruction should be performed with tube grafts, if possible. Aberrant renal arteries are reattached directly to the prosthesis. Dissection of renal isthmus should be avoided. Temporary cold renal perfusion is indicated to extend the ischemic tolerance time. As repair of a ruptured AAA in patients with HSK may be quite difficult and time consuming, we recommend more liberal indications for aneurysm surgery in patients with HSK.

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