J.Jpn. Surg. Soc.. 89(2): 297-301, 1988
Case report
A STAGED SURGICAL TREATMENT OF THE ABDOMINAL AND ILIAC ANEURYSM ASSOCIATED WITH HYDRONEPHROSIS AND URINOMA: REPORT OF A CASE
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The Department of Surgery and Radiology, Tsukuba Medical Center Hospital, Ibaraki, Japan Ikuo Fukuda, Tomoaki Jikuya, Shonosuke Matsusita, Kenmei Kuramoto |
The patient is 71 years-old female. She was admitted because of right lower abdominal pain. A diagnosis of the infrarenal abdominal aneurysm with involvement of the common iliac artery and right hydronephrosis due to ureter obstruction was made. A leakage of urine from right renal pelvis (urinoma) was also confirmed. A staged treatment for hydronephrosis was selected. At first, percutaneous nephrostomy was made under ultrasonographic guidance. Urinoma was completely disappeared there after. Two weeks later, the aneurysm was replaced with a Y-shaped Dacron graft and the right ureter was mobilized from the perianeurysmal fibrous tissue. On the 35th postoperative day, balloon uretero-plasty was performed through the nephrostomy catheter. Three months after operation, nephrostomy catheter was successfully withdrawn because of improved urinary passage through the right ureter.
We emphasize the efficacy of staged surgical treatment combined with percutaneous nephrostomy for the abdominal aneurysm associated with hydronephrosis.
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