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Case Report
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| Intra-parenchymal renal artery aneurysm in a young pregnant patient | ||||||
| Shariful Islam1, Devin Hosein2, Dave Harnanan3, Dilip Dan4 | ||||||
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1DM, Registrar, General Surgery, San Fernando Teaching Hospital, Trinidad & Tobago.
2MBBS, Senior House Officer, General Surgery, San Fernando Teaching Hospital, Trinidad & Tobago. 3DM, Lecturer, University of the West Indies, Department of Clinical Surgical Sciences, St Augustine Campus, Trinidad & Tobago. 4FACS, Professor of Minimally Invasive Surgery, Head of the Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, Trinidad & Tobago. | ||||||
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| How to cite this article |
| Islam S, Hosein D, Harnanan D, Dan D. Intra-Parenchymal renal artery aneurysm in a young pregnant patient. Int J Case Rep Images 2015;6(12):747–751. |
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Abstract
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Introduction:
Renal artery aneurysms are rare clinical entities with an estimated incidence of less than 1% with 10% of these aneurysms being associated with intraparenchymal aneurysms of the renal artery. The presentation of these aneurysms is highly variable. The consequences of missing the diagnosis can be catastrophic. Pregnancy increases the risk of rupture with these aneurysms and presents a dilemma for the managing physician. There are several methods of managing a renal artery aneurysm although no established guidelines exist. Surgical approaches range from endovascular techniques to open procedures such as ex-vivo aneurysmal repair with auto-transplantation, with a partial or total nephrectomy being reserved as techniques of last resort.
Case Report: We present a case of a 36-year-old primigravid female with a left renal artery aneurysm unsuitable for endovascular therapy. Attempt was made for laparoscopic donar nephrectomy, ex-vivo aneurysm repair with auto transplantation; however laparoscopic left nephrectomy was performed because of the intraparenchymal location of the aneurysm. Conclusion: Renal artery aneurysms should always be considered as a differential in patients with secondary hypertension. Close follow up is required if detected in pregnant patients as these increased the risk of fatal outcomes. Attempt should be taken to preserve the kidney function. A multi-disciplinary approach is required to decrease morbidity and mortality in these patients. | |
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Keywords:
Ex-vivo repair of renal artery aneurysm, Hypertension in pregnancy, Intraparenchymal renal artery aneurysm, Laparoscopic donar nephrectomy, Renal artery aneurysm
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Author Contributions
Shariful Islam – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Devin Hosein – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Dave Harnanan – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Dilip Dan – Substantial contributions to conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 Shariful Islam et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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