Postnephrectomy pseudoaneurysm with arteriovenous fistula

Abstract

Sonography detected a paraaortic pulsatile tubular mass in a patient 10 years after "stump" nephrectomy, which was subsequently confirmed as a renal artery-renal vein fistula by computed tomography, angiography, and laparotomy.

Is Enbloc Ligation of Renal Pedicle Safe During Laparoscopic Nephrectomy

“…Fistulas can form in cases where wound was packed or clamps were left in place after wound closure because of uncontrolled bleeding; this could indicate inadequate ligation of the vessels. 6,7 Even separately ligated renal vessels may retract within their sheath after transection and become adherent in cases of inflammation that can predispose the vessels to AVF formation.…”

Selective Transcatheter Embolization of a Pediatric Postnephrectomy Arteriovenous Fistula

“…Cardiac output rises because of increased heart rate and stroke volume. The increased work load affects both ventricles and leads to cardiomegaly [4], The traditional treatment of an arteriovenous fistula has been surgery with resection of the aneurysmal sac with suture of the vessels or ligature of the artery and vein [3,6,7,9]. With the development of transcatheter embolization techniques, nonsurgical occlusion of fistulas became a well-accepted treatment with a low risk of complications [5,8,11], However, percutaneous embolization of a post nephrectomy fistula in children has not been reported to our knowledge.…”

“…The causative fac tor is simultaneous ligation of the renal artery and the renal vein with transfixing sutures, along with infection [3], In mass ligation of the renal pedicle, an opening may be made between the artery and vein if they are injured simultaneously by a needle [6]. For protection of an arte riovenous fistula the vessels should be ligated separately, so that they retract within their sheats and become adher ent in the face of low-grade infection [6], Arteriovenous fistulas of the renal pedicle may develop over periods of days to years. The time between treatment Increased cardiac output is a compensatory mechanism for the steal of arterial blood toward the venous system and for the increased venous return to the right side of the heart.…”