Olgu Sunumu: Polikistik atnalı böbrek ile birlikte görülen rüptüre Standford tip B aortik diseksiyon

Yıl 2021, Cilt: 4 Sayı: 2, 64 - 66, 30.06.2021

Özgür Çakır , Zeki Talas , Demet Doğan

Öz

At nalı böbreği genellikle asemptomatiktir; ancak enfeksiyon, üreter taşları ve malignite gibi nedenlerle semptomatik hale gelebilir. Literatürde, yetişkin polikistik böbrek hastalığı ile ilişkili eşzamanlı durumlar arasında karaciğerde yaygın kistik lezyonlar, kolon divertikülü, kapak kalp hastalığı ve serebral arter anevrizması yer alır.
Hipertansiyon ve aktif sigara içimi dışında kayda değer bir tıbbi öyküsü olmayan ,60 yaşında erkek hasta, bulantı, kusma ve karın ağrısı şikayetleri ile acil polikliniğe başvurdu. Yapılan Bilgisayarlı tomografi (BT) incelemede; torasik aorttan iliak arterlere uzanım gösteren Standford tip B diseksiyon ve eşlik eden ve polikistik at nalı böbrek görüldü. Literatürde polikistik at nalı böbreği ve torasik aortun Stanford tip B diseksiyonunu bir arada var olduğunu gösteren herhangi bir çalışmaya rastlanmamıştır. Bu klinik bulgular eşliğinde BT görüntülerini ortaya koyan ilk olgu sunumudur.

Anahtar Kelimeler

polikistik böbrek, Atnalı, aortik diseksiyon

Polycystic horseshoe kidney with ruptured Stanford type B aortic dissection: Case report

Öz

Horseshoe kidney is usually asymptomatic; however, it may become symptomatic due to infection, ureteral stones and malignancy. In the literature, concomitant conditions associated with adult polycystic kidney disease include diffuse cystic lesions in the liver, colon diverticulum, valvular heart disease, and cerebral artery aneurysm. Our case; A 60-year-old male patient was admitted to the emergency clinic with complaints of nausea, vomiting and abdominal pain without a significant medical history other than hypertension and active smoking. Computed tomography (CT) revealed Stanford B type aortic dissection starting from the thoracic aorta to the iliac arteries and polycystic horseshoe kidneys with multiple cysts in the liver. Since the Stanford type B dissection of polycystic horseshoe kidney and thoracic aorta is rare, no study has been found in the literature to show their coexistence. This is the first case report that reveals the relationship between clinical findings and CT images in the literature.

Anahtar Kelimeler

Polycycstic kidney, Horseshoe, Aortic dissection

Kaynakça

• Referans1. 1. Ghonge N, Jasuja S. Polycystic horseshoe kidney: dealing with double trouble. Clin Kidney J Images in Nephrology. 2014; 7: 413.
• Referans 2. Brum FA, Becker M, Uglione A, Da Ros CT. Polycystic horseshoe kidney. J Urol .1997; 158(6): 2229.
• Referans 3. Cassell A, Jalloh M, Diop PS, et al. A Review of Rare Associations of Horseshoe Kidney: Highlight of a Rare Clinical Case of Polycystic Horseshoe Kidney, Liver Cyst, and Uterine Prolapse. EMJ Urol. 2020;8(1):22-28.
• Referans 4. Yildiz G, Hür E, Mağden K, Şen ST, Yilmaz A, Gürkan A. Polycystic Horseshoe Kidney and Polycystic Liver Disease. World Journal of Surgery and Surgical Research. 2019 Volume 2: p1-3.
• Referans 5. M Shahreyar, A Alfi, I Vagif, F Al-Mashat. Polycystic horseshoe kidney. Indian J Nephrol. 2005;15: 250-251.
• Referans 6. B Adhisivam, N Prahlad, M Vijayakumar, BR Nammalwar, S Muralinath Cardiovascular malformations associated with urinary tract anomalies. Indian J Nephrol. 2005;15: 8-9.
• Referans 7. Pardo FL, González AC, Maqueda IM, Bustos AR, González AS. Multiple Heart Valve Involvement in Renal Polycystic Disease in the Adult. Rev Esp Cardiol. 1994 Jun;47(6):403-6.
• Referans 8. Guvendi B, Ogul H. Left Renal Vein Compression and Horseshoe Kidney: An Extraordinary Association. Medical Principles and Practice. June 2016 25(5).