Preferred Language
Articles
/
iqjmc-1740
Rupture of renal artery aneurysm during cesarean section: a case report: Ruture of renal artery aneurysm r cesarean seection
...Show More Authors

 

Introduction:

Renal artery aneurysm (RAA) occurs to focal dilatation of artery secondary to weakness of the arterial intima and media. RAA is a rare clinical entity with an incidence of 0.01 – 1%.1

Rupture RAA during pregnancy is extremely rare event. The obstetric and urologic literatures are deficient in this regard. Diagnosis of rupture RAA during pregnancy is very difficult i.e. no pathognomonic presentation. When rupture occurs during pregnancy the clinical presentation is confused with those more common conditions e.g. placenta abruption or rupture uterus.

Most of the cases are discovered incidentally, even it is only diagnosed after autopsy.

Case presentation:

A fifth cesarean section was done for 30 years oldwomen presented with placenta previa. She was gravida 6 para 5. Cesarean section was an elective one. She gave a live birth male weighing 2.4 kg.  Hysterectomy was carried out after sever bleeding during operation. Ten units of blood were given in addition to other management steps. Urologists and general surgeon were consulted. The patient was dead. Exploration was done and revealed a rupture of left renal artery aneurysm.  

Discussion:

It was the 5th cesarean section for women. Literature documented that previous history of cesarean sections is the primary risk factor for developing placenta previa.1 Other risk factors are gestation with male fetuses and multiparity.3 The mentioned risk factors were characters of the reported case. It was stressed that multiple cesarean sections affect adversely the health of women.2 It was the 5thcesarean section.

RAA is an unusual diagnosis. Hemodynamic changes during pregnancy that is increased blood volume and cardiac output, raised intrabdominal pressure and hormonal alterations, affect the arterial wall and increased the risk of rupture RAA, more so in the 3rdtrimester.3 The reported case was gravida 6 which might enhanced the formation and rupture of RAA. It was reported that women with RAA and unusual number of women were multiparous.4

Owing to the pregnancy state, RAA was missed as cesarean section was planned for delivery of acase of placenta previa. The final diagnosis made only after exploration. It is the same as mentioned in literature.5

In this case, RAA was on the left side. Literature reported that RAA was often on the left side.4 Since 1970, published reports have not shown a left sided predominance of RAA.6

There are no previous reports of diagnosis of the intact RAA during pregnancy. This report might be the first one in Iraqi literature of rupture of RAA during pregnancy.

Conclusion: The possibility of a ruptured RAA should be considered in pregnant women with evidence of retroperitoneal hemorrhage. Imaging facilities should be available in theater rooms to be used immediately.  

References:

1- Oylele Y, Smulian JC. Placenta previa, placenta accrete and vasa previa. Obstet Gynecol 2006; 107: 927-941.
2- Seidman DS, Pazi I, Nadu A, Dollberd S, Stevenson DK, Gele R et al. Are multiple cesarean sections safe? Eur J Obstet Gynecol Reported Biol 1994; 57: 7-12
3- Porcaro AB, Migliorini F, Pianon R, Antoniothi SZ, Furlan F, De Biase V et al. Intraparenchymal renal artery aneurysms. Case report with review and update of literature. Int Urol Nephrol 2004; 36: 409-416.
4- Soliman KB, Shawky A, Abbas MM. Ammory M, Shoaban A. Rupture renal artery aneurysm during pregnancy. A clinical dilemma. BMU Urol 2006; 6: 22
5- Henke PK, Cardnean D, Welling III TH, Upchurch GR, Wakefield TH, Jacob L et al. Renal artery aneurysm: a 35-year clinical experience with 252 aneurysms in 168 patients. Annal of Surgery 2001; 214: 454-463.
6- Yang JC, Hye RJ. Ruptured renal artery aneurysm during the pregnancy. Ann Vasc Surg 1996; 10: 370-372.

 

2

 

Crossref
View Publication Preview PDF
Quick Preview PDF
Publication Date
Mon Mar 08 2021
Journal Name
Surgical Neurology International
Ruptured giant aneurysm of a cortical middle cerebral artery: A case report
...Show More Authors
Background:

Aneurysms of the cortical branches of the middle cerebral artery (MCA) are rare. They usually are secondary to traumatic or infectious etiologies and are rarely idiopathic. The specific characteristics of idiopathic aneurysms in such location are not well defined in the literature. The authors report a rare case of a ruptured giant idiopathic cortical MCA aneurysm with review of the available literature on this clinical entity.

Case Description:

A 24-year-old female presented with headache, disturbed level of consciousness, and right-sided weakness. Imaging studies showed a left frontoparietal intracer

... Show More
View Publication Preview PDF
Scopus (3)
Crossref (4)
Scopus Crossref
Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
Sellar hematoma as a new potential radiological clue for superior hypophyseal artery aneurysm rupture
...Show More Authors

Background. In cases of spontaneous subarachnoid haemorrhage (SAH) with multiple intracranial aneurysms (MIAs) detected on angiography, some radiological clues assist in determining the site of a ruptured aneurysm which is bleeding is quite beneficial for the selection of the best treatment strategy. Case description. We report a case of a 60 years old patient who presented with spontaneous SAH, sellar hematoma, and three different aneurysms detected in angiography. Although the right Posterior communicating artery (PcomA) aneurysms showed Murphy’s teat on angiography intraoperatively, we discovered that the right superior hypophyseal aneurysm (SHA) was the source of the index bleeding. Both aneurysms were clipped successfully. Co

... Show More
View Publication Preview PDF
Crossref (1)
Crossref
Publication Date
Wed Jul 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Case Report and review of literatures Common Carotid Artery Aneurysm and Subclavian Arterio-Venous Fistula
...Show More Authors

Vascular injury is still common in countries such as Iraq where both military and urban violence are endemic.
This is a report of a thirty eight year old civilian patient who had been inflicted with shrapnel injury during the 3rd. Gulf war, which had caused two different types of vascular injury with minimal evidence of vascular injury with evidence of only two small wounds in the neck and upper chest at the time of injury but presented few months later with a pulsatile neck mass and palpable thrill across the right supraclavicular area and upper chest.
Preoperative investigations were done including Doppler study and angiography which confirmed the presence of right common carotid artery aneurysm and

... Show More
View Publication Preview PDF
Crossref
Publication Date
Tue Sep 15 2020
Journal Name
Romanian Neurosurgery
Enlarged anterior communicating artery masquerading as intracranial aneurysm
...Show More Authors

Background. The anterior communicating artery (ACoA) complex consists of the ACoA, the pre-and post-communicating segments of the anterior cerebral artery, and the recurrent artery of Heubner. It is the most common site for anatomical variations in the circle of Willis. Such variations can mimic intracranial aneurysms. Case description. A 30-year-old female presented with recurrent episodes of extreme headache and bilateral tinnitus. A brain computed tomography (CT) scan showed no significant lesions, while her CT-angiography (CTA) showed an enlarged vascular lesion at the ACoA, raising the suspicion for an ACoA aneurysm. A repeated CTA revealed a rare anatomical variation with a pattern of cross dominance in the ACoA complex;

... Show More
View Publication Preview PDF
Crossref (1)
Crossref
Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
Delayed intraoperative rupture of clipped aneurysm during the awaking from anaesthesia
...Show More Authors

Introduction. Intraoperative rupture (IOR) of an aneurysm is a frightful complication that causes significant morbidity and mortality worldwide. IOR can be attributed to various parameters, including hypertension, increased intracranial pressure (ICP), fragility of the vessels, and inadequate anaesthesia. IOR due to insufficient anaesthesia is scarcely reported in the literature. Here, we describe a re-ruptured anterior communicating artery (ACoA) after incomplete clipping of the neck during craniotomy closure due to unintended early wake-up from anaesthesia with a discussion about the management. Case description. A 38-year-old male suddenly developed a severe headache, a brief loss of consciousness, and vomiting. Computed tomogr

... Show More
View Publication Preview PDF
Crossref
Publication Date
Tue Dec 10 2019
Journal Name
Journal Of The Faculty Of Medicine Baghdad
case report Intramuscular hemangioma: a rare case of hemangioma in biceps muscle
...Show More Authors

Intramuscular hemangiomas are rare asymptomatic angiomatous tumors , showing a slow growing pattern . We reported a rare case of biceps muscle hemangioma  in a 22-years-old man who presented with progressive swelling following a simple trauma four years ago , after examining the patient with ultrasound (US) ,computed tomography( CT) scan and magnetic resonance imaging (MRI), which was confirmed by histopathology later on .

View Publication Preview PDF
Crossref
Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
‘Peacock tail’ Clipping Technique for a Giant Middle Cerebral Artery Aneurysm: A Technical Note
...Show More Authors

Background: Giant middle cerebral artery (MCA) aneurysms are surgically challenging lesions. Because of the complexity and variability of these aneurysms, a customized surgical technique is often needed for each case. In this article, we present a modified clip reconstruction technique of a ruptured complex giant partially thrombosed middle cerebral artery aneurysm.

Case description: The aneurysm was exposed using the pterional approach. Following proximal control, the aneurysm sac was decompressed. Then, we applied permanent clips to reconstruct the aneurysm neck. The configuration of the aneurysm mandated a tailored clipping pattern to account for resi

... Show More
View Publication Preview PDF
Scopus Crossref
Publication Date
Thu Jun 15 2023
Journal Name
Romanian Neurosurgery
A giant A4-A5 distal anterior cerebral artery aneurysm treated with microsurgical clip reconstruction
...Show More Authors

Background. Aneurysms of the distal anterior cerebral artery (DACA) are uncommon; they often form near the pericallosal-callosomarginal junction and are typically small. To our knowledge, giant DACA aneurysms developing from the more distant parts of the anterior cerebral artery (ACA), A4-5, have been described only once in the literature. Case description. A 66-year-old gentleman reported with a brief loss of consciousness followed by weakness in his right lower leg. The patient was admitted with a Glasgow Coma Score (GCS) of 15. A computed tomography (CT) scan of the head revealed a left hyperdense mass in the frontal parasagittal supracallosal region. Contrast MRI revealed a heterogeneously enhancing mass measuring 35x30x25 mm. C

... Show More
View Publication Preview PDF
Crossref
Publication Date
Thu Jan 30 2014
Journal Name
Al-kindy College Medical Journal
Rising Rate of Cesarean Section
...Show More Authors

Cesarean section, which was introduced into clinical practice as a lifesaving procedure for both the mother and the baby, is one of the most common surgeries performed in modern obstetrics. Formerly it was performed in interest of the mother; currently it is frequently done for fetal indication. As other procedures of some complexity, its use follows the health care inequity pattern of the world; underuse in low income setting, and adequate or even unnecessary use in middle and high income setting (1).
The first modern cesarean section was performed by German gynecologist Ferdinand Adolf Kehrer in 1881. Cesarean section is often performed when a vaginal delivery would put the baby's or mother's life or health at risk. Many are also pe

... Show More
View Publication Preview PDF
Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Nurses' Knowledge and Practice about Cesarean Section
...Show More Authors

Objectives: The study aimed at the assessment of nurses' knowledge and practice concerning Cesarean Section.
Methodology: ٨ non-experimental approach was carried out throughout the present study with the application
of a descriptive design a for the study subject. The study was carried out at two maternity hospitals in Mosul
city namely Al-Barolo and AL Khansa Hospitals. ٨ purposively sample consist of (20) Nurse who are working
in operation theater. The questionnaire was used as a means of data collection; it comprised (3) major parts. Part
one presented the demographic data. Part two, consisted of items of Nurses’ knowledge about Cesarean Section.
While, part three consisted of items of Nurses’ practices about C

... Show More
View Publication Preview PDF