Résumé
Horseshoe kidney (HSK) occurs in about 0.25% of the population. Coincidence of HSK with abdominal aortic aneurysm (AAA) is rare. We describe a 70-year-old man with an infrarenal AAA coexistence with HSK diagnosed by 3D-CTA. Preoperative 3D-CT and Angiography showed two major renal arteries and an accessory artery arising from the anterior wall of aneurysm. The aneurysm was successfully replaced by knitted Dacron bifurcated graft without resection of the isthmus. The accessory renal artery was reconstructed to the graft. Renal infarction and renal dysfunction did not occur and the postoperative course was uneventful.
Résumé
We report a case of cholesterol crystal embolism (CCE) after coronary bypass surgery. A 65-year-old man with unstable angina and abdominal aortic aneurysm (AAA) underwent coronary artery bypass grafting (CABG). Coronary angiography (CAG) was performed at 30 days after surgery. Two weeks after the CAG, plantar cyanosis of both feet was observed and a renal dysfunction developed. A skin biopsy of the cyanotic lesion demonstrated characteristic cholesterol clefts in small submucosal arteries. Methylprednisolone (MPSL) and prostaglandin E 1 (PGE 1) were given for 3 days and 2 weeks, respectively. The patient's condition improved remarkably. Two months after the CAG, resection of AAA was performed and the postoperative course was uneventful. Diagnosis of CCE is difficult and its prognosis still remains poor. Therefore, we should keep this unusual complication in mind.