Splenorenal bypass in suprarenal aneurysm with solitary left kidney: a case report

Renal revascularization in patients with a solitary functioning kidney and a suprarenal abdominal aortic aneurysm (AAA) is a surgical challenge due to the risk of renal ischemia and postoperative renal dysfunction. We present a unique case in which a 69-year-old male with a solitary left kidney and suprarenal AAA was managed successfully with a preemptive splenic artery-to-left renal artery transposition (splenorenal bypass) followed by aneurysmorrhaphy. This approach preserved renal function and avoided ischemic insult during aortic reconstruction. At 2 years of follow-up, the patient maintains stable renal parameters and the reconstruction is patent, underscoring the utility of splenorenal bypass as a viable alternative in anatomically constrained and high-risk scenarios.