Early transient hydronephrosis after laparoscopic aortobifemoral bypass grafting Fabien Thaveau, MD, Yves-Marie Dion, MD, MSc, Geoffroy Warnier de Wailly,

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Presentation transcript:

Early transient hydronephrosis after laparoscopic aortobifemoral bypass grafting Fabien Thaveau, MD, Yves-Marie Dion, MD, MSc, Geoffroy Warnier de Wailly, MD, Marcel Dumont, MD, Bruno Laroche, MD Journal of Vascular Surgery Volume 38, Issue 3, Pages 603-608 (September 2003) DOI: 10.1016/S0741-5214(03)00232-5

Fig 1 Case 1. A, Angiogram shows an occluded left external iliac artery. ABF bypass surgery was offered because of developing atheromatosis in both common iliac arteries in this patient who had previous left external iliac artery dilatation. B, Angiogram shows reperfusion of a diseased left common femoral artery. C, Abdominal ultrasonogram obtained 1 month postoperatively reveals moderate hydronephrosis of the left kidney (arrows). D, Intravenous pyelogram obtained 1 month postoperatively shows the cause of the hydronephrosis to be a filliform zone (arrow) at the L5 level, which corresponds with the site where the ureter crosses the left leg of the prosthesis. Journal of Vascular Surgery 2003 38, 603-608DOI: (10.1016/S0741-5214(03)00232-5)

Fig 2 Case 1. Radioactive diuretic renogram obtained with magnesium 3–technetium 99m 37 days postoperatively. A, Radioactive renogram before furosemide injection, posterior view. Left kidney (L) shows excretory delay compared with the right (R). B, Excretion curves constructed from a region of interest of the whole kidneys demonstrate the same excretory delay as seen in the left kidney in A. C, Radioactive diuretic renogram obtained after furosemide stimulation (arrow), posterior view. D, Excretion curves after furosemide stimulation (arrow). Journal of Vascular Surgery 2003 38, 603-608DOI: (10.1016/S0741-5214(03)00232-5)

Fig 3 Case 1. Radioactive renogram obtained with magnesium 3–technetium 99m 6 months later. A, Radioactive renogram, posterior view, showing equal perfusion of left (L) and right (R) kidneys. Spontaneously without the need of diuretic, the renal cavities empty quickly. B, Excretion curves show equal excretory function of kidneys. Journal of Vascular Surgery 2003 38, 603-608DOI: (10.1016/S0741-5214(03)00232-5)

Fig 4 Case 2. A and B, Angiogram shows occlusion of the right common iliac artery and moderate stenosis of the left common iliac artery. C, Angiogram shows reperfusion of the right external iliac artery. D, Abdominal ultrasonogram obtained 17 days postoperatively reveals moderate left-sided hydronephrosis (arrows). Journal of Vascular Surgery 2003 38, 603-608DOI: (10.1016/S0741-5214(03)00232-5)

Fig 5 Case 2. A, Intravenous pyelogram, anteroposterior view, obtained 17 days postoperatively reveals delay in excretory function of the left kidney and a nearly obstructed segment of the left ureter (arrow) at L5 level. B, Intravenous pyelogram, lateral view, obtained on postoperative day 17 reveals forward displacement of the ureter (arrowhead) at the site of the nearly obstructed segment. C, Radioactive diuretic renogram obtained with magnesium 3–technetium 99m 3 l/2 months postoperatively. Left kidney (L) does not show any excretory delay or any sign of hydronephrosis. D, Same examination as in C. Excretion curves constructed from a region of interest of the whole kidneys are symmetric and normal, and show equal excretory function of both kidneys. Journal of Vascular Surgery 2003 38, 603-608DOI: (10.1016/S0741-5214(03)00232-5)