Stanford A型急性大動脈解離を合併した異所性腎を伴う腹部大動脈瘤の1例

Surgical Treatment of Abdominal Aortic Aneurysm with Ectopic Kidney with Stanford Type A Acute Aortic Dissection；Report of a Case

はじめに　Stanford A型急性大動脈解離で発見された異所性腎を有する腹部大動脈瘤（AAA）を経験した．大動脈解離は発症時には診断困難であったため，診断がついた亜急性期に手術を行った．AAAは二期的に手術を行った．右腎動脈が左総腸骨動脈分岐直後より分岐し，骨盤内に異所性腎として存在しており，異所性右腎動脈温存，腹部大動脈人工血管置換術を施行したので報告する．

We experienced a surgical case of Stanford type A acute aortic dissection with abdominal aortic aneurysm （AAA） associated with ectopic kidney. Computerized tomography did not detect any ulcer-like projections, but 3 days later, it appeared, and emergency surgery was performed. Second-stage surgery was selected and done later to repair AAA. The right kidney was an ectopic pelvic kidney. The renal arteries had branched off from the left common iliac artery, and the renal artery lumen narrowed. With a 4 Fr catheter, cold Ringer’s solution was given to protect the kidneys during surgery. The patient showed no deterioration of kidney function and made good progress. After rehabilitation, the patient had no complications and was discharged from the hospital.