Ruptured renal artery aneurysm during pregnancy, a clinical dilemma

被引:31
作者
Soliman K.B. [1 ]
Shawky Y. [1 ]
Abbas M.M. [1 ]
Ammary M. [2 ]
Shaaban A. [3 ]
机构
[1] Obstetrics Gynecology Department, Maternity and Children Hospital, Buraidah, Qassim
[2] General Surgery Department, King Fahd Specialist Hospital, Buraidah, Qassim
[3] Urology Department, King Fahd Specialist Hospital, Buraidah, Qassim
关键词
Renovascular Hypertension; Spontaneous Rupture; Solitary Kidney; Contralateral Kidney; Placental Abruption;
D O I
10.1186/1471-2490-6-22
中图分类号
学科分类号
摘要
Background: Rupture of a renal artery aneurysm (RAA) during pregnancy is a rare event, with a high mortality rate for both mother and fetus. Increased blood flow and intra-abdominal pressure, and vascular changes secondary to increased steroid production are postulated as contributory to the increased risk of rupture during pregnancy. Case presentation: We present here a case report of total avulsion of solitary kidney secondary to rupture of RAA in a pregnant patient with congenital absence of the contralateral kidney. The main indication for nephrectomy was severely damaged kidney. Diagnosis was made during operation and both mother and fetus were saved. There are no previous reports of an intact renal artery aneurysm diagnosed either antepartum or postpartum. Conclusion: The possibility of a ruptured RAA should be considered in pregnant women with evidence of retroperitoneal hemorrhage. This case was unusual because it occurred in a solitary kidney, during the third trimester of pregnancy. © 2006 Soliman et al; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 14 条
[1]  
Lumsden A.B., Salam T.A., Walton K.G., Renal artery aneurysm: A report of 28 cases, Cardiovasc Surg, 4, 2, pp. 185-189, (1996)
[2]  
Seppala F., Levey J., Renal artery aneurysm: Case report of a ruptured calcified renal artery aneurysm, Am J Surg, 48, pp. 42-44, (1982)
[3]  
Karsten K., Karsten W., Artur L., Stefan F., Bernhard G., Axel H., Ex vivo repair and renal autotransplantation for complex renal artery aneurysms in a solitary kidney, Ann Vasc Surg, 19, pp. 407-410, (2005)
[4]  
Lacroix H., Bernaerts P., Nevelsteen A., Hanssens M., Ruptured renal artery aneurysm during pregnancy: Successful ex situ repair and autotransplantation, J Vasc Surg, 33, 1, pp. 188-190, (2001)
[5]  
Bulbul M.A., Farrow G.A., Renal artery aneurysms, Urology, 40, 20, pp. 124-146, (1992)
[6]  
Yang J.C., Hye R.J., Ruptured renal artery aneurysm during pregnancy, Ann Vasc Surg, 10, 4, pp. 370-372, (1996)
[7]  
Ghanavati F., Lavin A., Ruptured renal artery aneurysm in a pregnant woman with solitary kidney, J Obstet Gynecol, 5, pp. 564-566, (2003)
[8]  
Dayton B., Helgerson R.B., Sollinger H.W., Acher C.W., Ruptured renal artery aneurysm in a pregnant uninephric patient: Successful ex vivo repair and autotransplantation, Surgery, 107, 6, pp. 708-711, (1990)
[9]  
Pliskin M.J., Dresner M.L., Hassell L.H., Gusz J.R., Balkin P.W., Lerud K.S., Larson A.W., A giant renal artery aneurysm diagnosed post partum, J Urol, 144, 6, pp. 1459-1461, (1990)
[10]  
Martin R.S., Meacham P.W., Ditesheim J.A., Mulherin J.L., Edwards W.H., Renal artery aneurysm: Selective treatment for hypertension and prevention of rupture, J Vas Surg, 9, 1, pp. 26-34, (1989)