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[Isolated hypogastric artery aneurysm ruptured into urinary bladder: a case report]
M Moriyama1, C Nakajima, R Ikeda
1Department of Urology, Kanazawa Medical University.
Hinyokika Kiyo. Acta Urologica Japonica
|June 1, 1993
Summary
A large abdominal aortic aneurysm caused urinary obstruction and kidney damage in an elderly man. Surgical intervention with fibrin sealant and nephrostomy stabilized renal function.
Area of Science:
- Vascular Surgery
- Urology
- Radiology
Background:
- Abdominal aortic aneurysms (AAAs) can cause significant morbidity.
- Urinary tract obstruction is a rare but serious complication of AAAs.
Observation:
- An 81-year-old male presented with dysuria and a palpable abdominal mass.
- Imaging revealed left hydronephrosis, right renal non-function, and bladder compression by a large, calcified pelvic mass.
- The mass was suspected to be a recurrent or pseudoaneurysm.
Findings:
- A diagnostic excretory urogram (DIP) and computerized tomography (CT) confirmed urinary tract compression.
- Cystography demonstrated communication between the mass and the bladder.
- Surgical exploration revealed an unresectable aneurysm; fibrin sealant injection and bilateral nephrostomy were performed.
Implications:
- This case highlights the importance of considering vascular complications in patients with urinary symptoms.
- Minimally invasive techniques like fibrin sealant injection can be valuable when aneurysm resection is not feasible.
- Successful management preserved renal function in a complex clinical scenario.