Intra-parenchymal renal artery aneurysm in a young pregnant patient

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.

並列關鍵字

Ex-vivo repair of renal artery aneurysm ； Hypertension in pregnancy ； Intraparenchymal renal artery aneurysm ； Laparoscopic donar nephrectomy ； Renal artery aneurysm

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