[A case of surgical treatment of post-traumatic false arteriovenous aneurysm of the right kidney vessels].
This paper describes an experience gained with successful surgical correction of post-traumatic false aneurysm of the right kidney vessels in a 36-year-old patient operated on previously for knife wound and intrahepatic abscess. All-round examination (duplex scanning of the renal arteries, multispiral computed tomography, abdominal aortography, and ultrasonography of the kidneys) revealed a false aneurysm of the medium segment of the right kidney artery measuring 31x21x33 mm. The aneurysm was located downwards, to the rear and inwards from the artery, with marginal posteroinferior calcification drained to the venous collector (the right kidney vein) expanded to 36-40 mm. The preoperative diagnosis: a post- traumatic false arteriovenous aneurysm of the right kidney vessels; vasorenal hypertension; IIa stage circulatory insufficiency; chronic pyelonephritis, remission; hydronephrosis on the right; 0-I stage chronic renal insufficiency. In view of the failure of the attempts to accomplish endovascular intervention, progression of right ventricular heart insufficiency, the presence of vasorenal hypertension, and right kidney malfunction we performed operation which consisted in evacuation of the false arteriovenous aneurysm of the right kidney artery, plasty of the defect of the right kidney vein and of the defect of the right kidney artery by the aneurysmal wall. The postoperative period was uneventful. Control ultrasonography failed to discover arteriovenous shunting at the level of the right kidney arteries. Also, auscultation did not reveal any murmur in the projection of the renal vessels on the right and above the abdominal aorta. On the 14th postoperative day the patient was discharged from the clinic in a satisfactory condition. His laboratory and hemodynamic parameters were good.