[Abdominal compartment syndrome in an urological patient]. / Sindrome compartimental abdominal en un paciente urológico.

OBJECTIVES: Abdominal compartment syndrome is an infrequent clinical entity, the course of which has a rapid progression with multiorgan compromise leading to a fatal outcome if appropriate and urgent action is not undertaken. METHODS AND RESULTS: We report the clinical case of a patient who developed the clinical picture after renal trauma. Diagnosis was obtained by CT scan and arteriography, afterwards the patient required ICU admission with intra-abdominal pressure monitoring, and several decompression laparotomies before definitive closure with a reabsorbable mesh. CONCLUSIONS: Urologists should know the existence of this syndrome its appropriate treatment, because we manage patients who are candidates to suffer it. Due to the high mortality rate associated, it is essential to know how to recognize it in order to act fast.

[Renal transplant in a patient with aortobifemoral bypass]. / Trasplante renal en paciente con bypass aortobifemoral.

OBJECTIVES: Over the last few years we see an increase in the number of patients with vascular disease who need a renal transplant. We discuss their management and different therapeutic options available. METHODS/RESULTS: We report the case of a female patient with history of systemic vascular disease having undergone multiple surgical procedures for it, including aortobifemoral bypass, presenting with end stage renal disease. A kidney transplant into the right iliac fossa was carried out with end to side vascular anastomosis to the iliac vein and arterial vascular prosthesis, respectively. The main difficulty came from the existence of an important fibrosis around the prosthesis, which forced a much more careful dissection of the iliac vein. Immediate postoperative course was uneventful, and the graft shows a normal function two years after surgery. CONCLUSIONS: The coexistence of vascular and renal disease is not a contraindication for kidney transplantation. Larger experience is required, but published data to date do not show significant differences on graft or patient survival.