Abdominal aortic aneurysm associated with crossed renal ectopia without fusion: Case report and literature review

Abstract

Genitourinary anomalies can present a formidable challenge to the vascular surgeon at abdominal aortic reconstruction. We saw a case of crossed renal ectopia without fusion, a rare anomaly, associated with abdominal aortic aneurysm. Because of risk for injury to the kidney during surgery, preoperative evaluation of this anomaly must include computed tomography, angiography, and intravenous pyelography. Preoperative placement of a ureteral catheter may prevent injury to the anomalous ureter. Renal failure of the ectopic kidney during aortic reconstruction can be a serious problem. We used in situ hypothermic perfusion with cold (4 degrees C) Ringer solution for renal protection, and reimplanted the aberrant renal artery. The postoperative course was good, without major complications. The procedure for renal preservation must be selected on the basis of anatomic findings. We review the literature and present the first case of crossed renal ectopia.

Pelvic kidney and related anomalies - A case report

“…The blood supply of an ectopic kidney can vary. There can be more than one aberrant artery and aberrant arteries can originate from the abdominal aorta, common iliac artery, external iliac artery or inferior mesenteric artery 3 . Similar finding was also observed in the present case but right kidney was slightly hypertrophopized.…”

The Importance of Venous and Renal Anomalies for Surgical Repair of Abdominal Aortic Aneurysms

“…In this anomaly, the kidneys, including the nonectopic kidney, have an anomalous blood supply. (Yano et al, 2003) …”

“…Because arteries not identified at preoperative arteriography are occasionally found at surgery, too much confidence should not be placed on preoperative evaluation. To minimize the risk for complications, it also could be placed a ureteral catheter for intraoperative identification (Yano et al, 2003). …”

“…This shows that the ureter crosses the midline, and enters the bladder at its normal anatomic location. (Yano et al,2003).…”

Crossed renal ectopia with fusion: Report of two patients

“…Demonstration of a congenital renal anomaly is important in the treatment of patients with renal infection and in surgery of the urinary system (Bhatnagar et al, 2004;Stimac et al, 2004). Crossed renal ectopia, in which one of the kidneys lies on the contralateral side but whose ureter passes to the ipsilateral side, is the second most common renal fusion anomaly following horseshoe kidney (Kwon et al, 2004), and in different autopsy series it is detected in 1 in 1,000 to 1 in 7,000 (Hwang et al, 2002, Yano et al, 2003Guarino et al, 2004). It is more often seen in postmortem studies than in clinical practice.…”