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Resumen Los riñones ectópicos pélvicos solitarios asociados a degeneración aneurismática de las arterias ilíacas y la aorta abdominal son eventos muy raros. Los enfoques quirúrgicos para la corrección de aneurismas con compromiso renal son un desafío por la falta de consenso actual, en especial cuando cursan con riñones ectópicos pélvicos solitarios funcionales asociados. Por tal motivo, una de las estrategias que ha demostrado buenos resultados a corto y mediano plazo es la nefroprotección en frío, la cual puede ser usada con seguridad en estos pacientes. En el caso que se presenta, se evidenció una ectasia aórtica con aneurismas ilíacos bilaterales asociados con un riñón ectópico pélvico solitario en un paciente masculino de 75 años, con hipertensión arterial y dislipidemia. Se realizó una reconstrucción aortoilíaca bilateral y una reconstrucción de la arteria hipogástrica, además de reimplante de la arteria renal ectópica bajo irrigación renal en frío, sin complicaciones y preservación de la función renal.
Abstract Solitary pelvic ectopic kidneys associated with aneurysmal degeneration of the iliac arteries and abdominal aorta are very rare events. Surgical approaches for the correction of aneurysms with renal involvement are challenging due to the lack of current consensus, especially when they are associated with functional solitary pelvic ectopic kidneys. For this reason, one of the strategies that has shown good results in the short and medium term is cold nephroprotection, which can be used safely in these patients. In the present case, aortic ectasia with bilateral iliac aneurysms associated with a solitary pelvic ectopic kidneys was evidenced in a 75-year-old male patient with arterial hypertension and dyslipidemia. Bilateral aortoiliac reconstruction was performed with hypogastric artery reconstruction and reimplantation of the ectopic renal artery under cold renal irrigation, without complications and preservation of renal function.
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Humans , Male , Abdomen , Aorta, Abdominal , Cadaver , Colon, Sigmoid , Deception , Kidney , Pelvis , Renal Veins , Sacrum , VeinsABSTRACT
ABSTRACT Anorectal malformations have long been associated with multiple other anomalies, commonly referred to as the VACTERL complex. We present a case of a newborn baby girl with an unusually high number of associated anomalies, including the rarely encountered condition of uterus didelphys.
RESUMEN Las malformaciones anorrectales se han asociado por mucho tiempo con otras anomalías, conocidas comúnmente como asociación VACTERL. Presentamos el caso de una niña recién nacida con un número inusualmente alto de anomalías asociadas, incluyendo una condición raramente encontrada conocida como útero didelfo.
Subject(s)
Humans , Female , Infant, Newborn , Uterus/abnormalities , Duodenal Obstruction/congenital , Anorectal Malformations , Fatal OutcomeABSTRACT
Objective To evaluate the efficacy and safety of the flexible ureteroscopy (FURS) with holmium laser lithotripsy in the management of stones in ectopic pelvic kidney (PK).Methods We retrospectively reviewed the records of 11 patients,ranged from 37-52 years old,who were underwent FURS with holmium laser for PK stones from January 2007 to April 2012.Three cases had solitary stones in renal pelvis,3 cases had solitary stones at lower calyx and multiple stones were found in 5 cases.Mean size of stone was 2.3 cm (ranged 1.8-3.7 cm).One case had history of ESWL and PCNL before surgery with unsatisfied result and 7 cases were underwent ESWL with poor outcome.The double J stent was placed into the ureter two weeks before the operation.Under the general anesthesia,the ureteral access sheath was placed firstly during operation.Then,flexible ureteroscopy was inserted into the renal pelvis through ureteral access sheath.Holmium laser was used to perform the procedure with the power less than 20 W (0.6-1.0 J/10-20 Hz).The stone fragments were taken out by stone baskets and double-J stent was set at the end of the procedure for additional two weeks.Results The successive rate of the ureteroscopic insertion was 100％.The average operation time was 62 min (ranged 31-87 min).No severe complications such as heavy bleeding,perforation or ureteral avulsion occurred.Small stone fragments were found in 3 cases.All of them located in the lower calyx.Since no one complained about the upper urinary obstruction or related symptoms,conservative observation was considered.All patients discharged the day after the operation.Within three months follow-up,no sign of urinary obstruction was found.Conclusions FURS with holmium laser is a safe,effective and minimally invasive technique.It could be the best option in the management of renal calculi in ectopic pelvic kidney.
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We present the case of a 68-year-old woman with abdominal aortic aneurysm (AAA) complicated by right ectopic kidney, in another term, congenital pelvic kidney. The patient underwent AAA repair and right renal artery reconstruction using renal perfusion with cold Ringer's acetate, and no deterioration of renal function was observed. 3D-CT was essential diagnostic procedure in order to identify the blood supply to the ectopic kidney for planning a careful surgical technique.
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A two-month old female child presenting with recurrent febrile urinary tract infection (UTI) was diagnosed to have a single-system pelvic kidney and a contralateral incomplete ureteral duplication with associated bilateral ectopic obstructive megaureters draining into the proximal urethra. Bilateral cutaneous loop ureterostomy was done at that time. Subsequently, she underwent undiversion, transuretero-pyelostomy (double left ureters to right pelvis), right ureteroneocystostomy, and augmentation ureterocystoplasty. Biopsy of the right distal ureter was consistent with megaureter with acute and chronic ureteritis. Repeat IVP post-op showed well-opacified kidneys with no signs of obstruction and a well-distended urinary bladder with moderate post-void residual urine. A high index of suspicion, coupled with meticulous physical examination and rationally combined diagnostic procedures are important to make a diagnosis of a unique combination of rare congenital urologic anomalies. (Author)
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The Mayer-Rokitansky-Kuster-Hauser syndrome represents aplasia of the Mullerian duct, which leads to absence of the uterine corpus, the uterine cervix and the upper portion of the vagina. We experienced a case of this anomaly which combined with single pelvic kidney in 21-year-old female.
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Female , Humans , Young Adult , Cervix Uteri , Kidney , VaginaABSTRACT
The pelvic kidney, which is located opposite the sacrum and below the aortic bifurcation is art ectopic renal mass with a congenitally short ureter and aberrant blood supply. The pelvic kidney may be assumed that any factors arresting the cranial migration of the ureteral buds. Genital anomalies are frequently associated in renal ectopia, which are affected on uterus and proximal vagina in female patient. We have experienced a case of congenital solitary pelvic kidney with amenorrhea in 21-year-old female patient.q