scholarly journals A Case of Left Retroexternal Iliac Artery Megaureter Associated with Additional Renal and Vascular Congenital Anomalies

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Amin A. Karadaghy ◽  
Matthew T. Bell ◽  
Daniel T. Daly ◽  
Yun Tan
Keyword(s):  
Urinary Tract ◽  
Iliac Artery ◽  
Secondary Infection ◽  
Left Kidney ◽  
Clinical Manifestations ◽  
Current Case ◽  
Median Sacral Artery ◽  
Precise Knowledge ◽  
Internal Iliac ◽  
The Right

Introduction. A number of rare anatomical anomalies, including retroexternal iliac ureter, extrarenal calyces (ERCs), and vascular anomalies, were observed in a 96-year-old female cadaver during a routine dissection. Description. A markedly dilated left extrarenal pelvis (ERP) with a diameter of 3.15 cm was noticed. Three major calyces were found outside of the normal-sized left kidney. The abdominal aorta (AA), instead of normal bifurcation, branched to the right common, left external, and left internal iliac arteries. The median sacral artery was a direct branch from the right common iliac artery. No hydronephrosis was observed on the affected side, and no urinary tract anomalies were observed on the right side. Significance. The retroiliac megaureter is a rare congenital anomaly, with fewer than 25 cases reported to date. Additionally, the ERCs are amongst the rarest anomalies of the renal collecting system. Further, the current case is one of few reported cases where the particular branching pattern of the AA was observed. The combination of such anatomical anomalies is rare, and the relationship between them is unclear. Common clinical manifestations of retroiliac ureters are the results of ureteric obstruction, hydronephrosis, and secondary infection. Precise knowledge of anomalies of the kidney and urinary tract can help radiologists and surgeons make a definitive diagnosis and prevent inadvertent injury during surgery.

Morphoconstitutional analysis of a series of 166 urinary stones in Western Algeria for a period of two years (2015-2017)

2018 ◽  
Vol 7 (3) ◽  
pp. 107-112
Author(s):  
Bouzana Fatima ◽  
Sbahi Khayra ◽  
Kerroumi Slimane ◽  
Attar Abderahmane ◽  
Seghir Madjhouda Omar ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Sequential Analysis ◽  
Left Kidney ◽  
Urinary Stones ◽  
Female Ratio ◽  
Composition And Structure ◽  
Male Female Ratio ◽  
Anatomical Localization ◽  
Western Algeria ◽  
The Right

A stone is not only an obstacle, sometimes painful, on the urinary tract justifying an emergency urological gesture to restore their permeability. It is primarily a symptom of crystallogenic pathologies or urinary imbalances of nu-tritional origin whose recurrence is the rule if the cause has not been correctly identified. It is therefore recommended in the patient's interest; analyze the calcul or its fragments to determine its composition and structure, one and / or the other orienting towards the pathology in question. A series of 166 urinary stones were collected nearby the hospitals of western Algeria after urological intervention or spontaneous expulsion and sequential analysis of the nucleus at the surface by Fourier transform infrared spectrophotometry. The male / female ratio was 1.78. The study of the anatomical localization of the stones showed a predominance of the high urinary tract with a rate of 76.9%. 27.3% of the stones were located in the left kidney compared to 25.7% in the right kidney. Analysis of the crystalline composition showed that calcium oxalate was predominant in 65.8% of the calculs and in 58.5% of the nuclei. In all, whewellite was present in 46.9% of cases and weddellite in 18.9%. uric acid anhydrous was the major component of 12.2% of the calculations analyzed. It was present in 23.3% of cases with predominance in subjects over 60 years. Our results show that the lithiasis of the urinary tree in western Algeria tends to evolve in the same direction as that of the industri-alized countries.

Isolated internal iliac artery infected pseudoaneurysm occlusion using endovascular coil embolisation

2021 ◽  
Vol 14 (6) ◽  
pp. e239005
Author(s):  
Gorrepati Rohith ◽  
Bachavarahalli Sriramareddy Rajesh ◽  
KM Abdulbasith ◽  
Sathasivam Sureshkumar
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Coil Embolisation ◽  
Incision And Drainage ◽  
Wound Debridement ◽  
Anterior Branch ◽  
Ct Angiogram ◽  
Internal Iliac ◽  
Infected Pseudoaneurysm ◽  
The Right

A 34-year-old man presented with painful swelling in the right gluteal region. The MRI showed right sacroiliitis and adjacent intramuscular abscess. The abscess was drained by a pigtail insertion followed by incision and drainage. The patient developed persistent bleeding from the drainage site. CT angiogram revealed a large pear-shaped pseudoaneurysm arising from the anterior branch of the right internal iliac artery. The patient had Abrus precatorius poisoning previously resulting in methicillin-resistant Staphylococcus aureus septicaemia, which incited above events. Digital subtraction angiography with coil embolisation of the right internal iliac artery was done under the cover of culture-specific antibiotics along with thorough wound debridement following which the patient’s condition improved. Isolated infected pseudoaneurysms of internal iliac arteries, although rare, should be considered in cases of complicated sacroiliitis. Under antibiotic cover, endovascular coil embolisation can be considered as a treatment strategy to treat complicated infected pseudoaneurysms located in difficult anatomical locations.

scholarly journals Morphological considerations on the origin and morphometry of the internal iliac arteries

2014 ◽  
Vol 20 (4) ◽  
pp. 219-227
Author(s):  
Oana Popa ◽  
P. Bordei ◽  
D. Iliescu ◽  
C. Ionescu
Keyword(s):  
Intervertebral Disc ◽  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Single Case ◽  
Front Face ◽  
Iliac Arteries ◽  
Internal Iliac ◽  
The Right ◽  
Different Levels ◽  
Internal Iliac Arteries

Abstract The origin of the internal iliac artery, right and left, was studied in 76 cases, 58 cases of male (76.32% of all cases) and 18 female cases (23.68% of all cases). The origin of the internal iliac arteries was considered in relation to the spine (lumbar-sacral). The right internal iliac artery males originates in a range from the upper edge of L4 vertebra - the lower part of fin sacral. It is found that in males, in most cases, 43 cases (74.14% of male cases), right internal iliac artery originates at different levels of sacral fin. We considered that the right iliac artery low origin only the cases in the lower part of the fin sacral, 10 cases (17.24% of male cases). Cases of high origin of the artery, above the fin sacral we found it in 15 cases (25.86% of male cases). From high origins, in the upper edge of the L4 vertebra and intervertebral disc at L4-L5, I met only one single case. Right internal iliac artery in females originated in a range between the upper edges of L5 - the lower part of sacral fin. In females, the right internal iliac artery origin, is located within narrower than in men, but in women, most frequently, 14 cases (77.78% of female the cases) was the origin of the internal iliac located at different levels of sacral fin. The females have not met internal iliac origin above the L5 vertebra or intervertebral disc level L4-L5. High origin was met it in 4 cases (22.22% of female the cases) and low origin in 6 cases (33.33% of female the cases). The level of the left internal iliac artery origin we studied 78 cases, finding it in the same range as in males, i.e., the upper edge of L4 vertebra - the front of the sacrum. In males, on a number of 57 cases (73.08% of all cases) the origin of the left internal iliac artery was made between the upper edge of the vertebra L4 - the front face of the sacrum, most commonly, in 44 cases (77 19% of male the cases) located in the sacral fin. The artery high origin I found it in 9 cases (15.79% of male the cases) and low origin in 18 cases (31.58% of male the cases). I have not met artery origin at L5-S1 intervertebral disc. In terms of low origin, only in males, the left internal iliac artery originated from the anterior to the sacrum, something not found the right internal iliac artery. In females, the 18 cases followed, had their origins in the range lower half of the L5 - middle sacral fin, 17 cases (94.44% of female the cases), terminating at the sacral fin. It is found that in women the origin of the left internal iliac artery is within narrower than the other cases described so far, showing the highest level of origin, this artery in females do not possess low origin. The high origin is present in a small percentage, only 5.56% of cases, encountering any case the origin of the left internal iliac artery is located at the L4 vertebra or the intervertebral discs at L4-L5 or L5-S1. Internal iliac artery diameter was followed on 90 cases, 44 cases for the right internal iliac artery and 46 cases for left internal iliac artery. In males, the right internal iliac artery I found a caliber between 3 to 9.8 mm. In women the right internal iliac artery caliber found between 3.9 to 6.9 mm.

scholarly journals Collateral development and arteriogenesis in hindlimbs of domestic swine after ligation of arterial inflow

2018 ◽  
Author(s):  
NS Patel ◽  
Y Gao ◽  
S Aravind ◽  
M Fuglestad ◽  
GP Casale ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Hindlimb Ischemia ◽  
Artery Ligation ◽  
Luminal Diameter ◽  
Internal Iliac ◽  
Collateral Pathways ◽  
The Common ◽  
The Right ◽  
Domestic Swine

ABSTRACTIntroductionThe development of collateral vasculature is a key mechanism compensating for arterial occlusions in patients with peripheral artery disease (PAD). We aimed to examine the development of collateral pathways after ligation of native vessels in a porcine model of PAD.MethodsRight hindlimb Ischemia was induced in domestic swine (N=11, male, kg) using two different versions of arterial ligation. Version 1 (N=6) consisted of ligation/division of the right external iliac, profunda femoral (RPFA) and superficial femoral arteries (RSFA). Version 2 (N=5) consisted of the ligation of Version 1 with additional ligation/division of the right internal iliac artery (RIIA). Development of collateral pathways was evaluated with standard angiography at baseline (prior to arterial ligation) and at termination (4-8 weeks later). Relative luminal diameter of the arteries supplying the ischemic right hindlimb were determined by 2D angiography, as percent of the size of the distal aortic diameter.ResultsThe dominant collateral pathway that developed after version 1 ligation connected the RIIA to the RPFA and RSFA/popliteal artery. Mean luminal diameter (± standard error) of the RIIA at termination increased by 38% (P<0.05) compared to baseline. Two co-dominant collateral pathways developed in version: (i) from the common internal iliac trunk and left internal iliac artery to the reconstituted RIIA, which then supplied the RPFA and RSFA/popliteal arteries; and (ii) from left profunda artery to the reconstituted RPFA. Mean diameter of the common internal iliac trunk and left profunda artery both increased at termination in the range of 20% (p < 0.05).ConclusionTwo versions of hindlimb ischemia induction (right ilio-femoral artery ligation with and without right internal iliac artery ligation in swine produced differing collateral pathways, along with changes to the diameter of the inflow vessels (i.e., arteriogenesis). Radiographic and anatomical data of the collateral formation in this porcine model should have value in investigation of the pathophysiology of hindlimb ischemia, and assessment of angiogenic therapies as potential treatments for PAD.

scholarly journals Bilateral Giant Hydronephrosis Secondary to Ureteropelvic Junction Stricture: a Case Report

2021 ◽  
Author(s):  
Samet Senel ◽  
Yalcin Kizilkan ◽  
Serdar Toksoz
Keyword(s):  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Left Kidney ◽  
Current Case ◽  
Giant Hydronephrosis ◽  
Widespread Availability ◽  
The Right ◽  
Time Of Admission

Abstract Introduction: Giant hydronephrosis, which implies a collecting system containing more than one liter of fluid, is becoming increasingly rare with the widespread availability of imaging facilities. We aimed to report a case and management of bilateral giant hydronephrosis due to bilateral ureteropelvis stenosis.Case presentation: A 45-year old male presented at the Emergency Department with the complaint of difficulty passing stools. On computed tomography (CT), bilateral giant hydronephrosis was determined covering the whole abdomen. After bilateral nephrostomy, 8 liters of urine was drained from the right kidney and 10 liters of urine from the left kidney after bilateral nephrostomy in the patient whose serum creatinine level was 1.06 mg/dl at the time of admission. Bilateral pyeloplasty was applied to the patient who was diagnosed with bilateral ureteropelvis stenosis after dynamic renal scintigraphy. After 4 years of follow-up, serum creatinine level was 1.3 mg / dl. Hydronephrosis was still present despite being smaller than its previous condition and the presence of bilateral double J stents.Conclusions: An interesting finding of the current case was that the creatinine level might be normal despite the fact that bilateral giant hydronephrosis. So rather than nephrectomy, pyeloplasty was applied and to date there has been no need for hemodialysis.

scholarly journals A Unique Indication for the Altura Endograft to Repair Bilateral Common Iliac Artery Aneurysms Associated with a Short–Infrarenal Aorta

Aorta ◽  
2020 ◽  
Vol 08 (02) ◽  
pp. 041-045
Author(s):  
Stavros K. Kakkos ◽  
Chrysanthi P. Papageorgopoulou ◽  
Konstantinos Katsanos ◽  
Peter Zampakis ◽  
Athina Siampalioti ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Artery Aneurysm ◽  
Infrarenal Aorta ◽  
Iliac Artery Aneurysm ◽  
Internal Iliac ◽  
The Right ◽  
Stage Renal Disease ◽  
End Stage ◽  
Tomographic Angiography

AbstractA 71-year-old man with end-stage renal disease on hemodialysis presented with bilateral common iliac artery aneurysms diagnosed during the workup of his chronic kidney disease. On computed tomography angiography, common iliac artery aneurysm diameters measured 6.1 cm on the right side and 3.1 cm on the left side. The infrarenal aorta also had a small 3.2-cm aneurysm, but the length from the lowest left renal to the aortic bifurcation was only 6.7 cm, precluding use of most bifurcated endografts. Following an uneventful staged preoperative internal iliac artery embolization, a two-piece D-shaped Altura endograft for the aorta, with bilateral iliac components, landing at the level of the external iliac arteries was successfully performed. Postoperative course was uneventful with no endoleak or endograft migration on computerized tomographic angiography 45 days later, although billowing mimicking an endoleak was evident and will be closely followed.

Unusual Representation of a Common Iliac Artery Double Aneurysm

2017 ◽  
Vol 41 (3) ◽  
pp. 129-134
Author(s):  
Janine Oliveri
Keyword(s):  
Abdominal Aorta ◽  
Iliac Artery ◽  
Coil Embolization ◽  
Common Iliac Artery ◽  
Artery Aneurysm ◽  
Ultrasound Screening ◽  
Vascular Surgeon ◽  
Ultrasound Study ◽  
Internal Iliac ◽  
The Right

This case discusses an unusual representation of a 3.1-cm double aneurysm of the right common iliac artery with an ectatic distal abdominal aorta. The patient was a 64-year-old asymptomatic male who participated in a routine ultrasound screening at his church. On the basis of the findings, a full ultrasound study was ordered and conducted at the request of his primary physician. The patient's history included smoking cessation in 1975. He currently had hypertension and hyperlipidemia. He was physically active and ran 40 miles per week until developing right Achilles tendonitis. Because of this injury, the patient biked daily. The patient's medications included atenolol and daily vitamins. The ultrasound findings revealed two aneurysms of the right common iliac artery. Both areas were fusiform and measured 3.1 and 2.9 cm, respectively. The dilation extended to the right internal iliac artery. The left common iliac was mildly dilated and kinked to the left. There was mild enlargement of the distal abdominal aorta measuring 3.4 cm by ultrasound and 3.1 cm by computed tomography angiogram. There is no evidence of internal thrombus. Usually asymptomatic, iliac artery aneurysms can be lethal if large (above 3.0 cm) and undetected. With appropriate, timely intervention the aneurysm can be safely repaired before rupture. Various aneurysm treatment options include conventional open abdominal surgery or endovascular stent graft placement with coil embolization. This patient discussed options with the vascular surgeon and was scheduled to have a cardiac catheterization with right internal iliac coil embolization. Staging of the endovascular graft was planned to follow. This case presents the uncommon finding of a large iliac artery aneurysm. This patient's disease was made more unusual by the presence of two distinct aneurysms present within the same vessel. It further reinforces the common practice of fully examining patients with aneurismal disease bilaterally and over multiple levels as a significant portion of patients have multilevel disease.

scholarly journals Complicated Urinary Tract Tuberculosis in a 13-Year-Old Adolescent with Chronic Kidney Disease and Antituberculous Drug-Induced Hepatotoxicity

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Heda Melinda Nataprawira ◽  
Adhitya Agung Pratama ◽  
Ahmedz Widiasta ◽  
Jupiter Sibarani ◽  
Dany Hilmanto ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Left Kidney ◽  
Complicated Urinary Tract Infection ◽  
Significant Loss ◽  
Mantoux Test ◽  
British Thoracic Society ◽  
Drug Induced ◽  
Diuretic Renogram ◽  
The Right ◽  
Tract Infections

Urinary tract tuberculosis (TB) is a rare extrapulmonary manifestation of TB in children. The disease is potentially underdiagnosed because it clinically resembles other urinary tract infections. A 13-year-old adolescent girl presented with pain, difficulty in micturition, and gross hematuria for almost two years before admission, and she had left flank pain since one year ago and significant loss of body weight during the illness. The close TB contact was her grandmother who was on TB treatment. Acid-fast bacilli yielded positive result, Mantoux test was positive (17 mm), urine GeneXpert MTB/Rif was positive; tuberculoma was identified on kidney histopathology, and a diuretic renogram revealed an uncorrected glomerular filtration rate (GFR) of the right and left kidney to be 32.5 mL/min/1.73 m2 and 5 mL/min/1.73 m2, respectively. During the treatment, oral anti-TB drug-induced hepatotoxicity (ADIH) occurred to the patient. This problem was solved with management according to the British Thoracic Society (BTS) guidelines. Screening TB in children is very important for a better outcome. If children complain of some complicated urinary tract infection, TB should be suspected. Optimaly treating children with urinary tract TB exagerrated with ADIH and CKD is very challenging.

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