Abstract
This article describes a case of successful repeated surgical treatment for correction of residual phlebohypertension of the left kidney after primary transposition of the mouth of the left renal vein in a patient with NCS, with such clinical manifestations as: severe pain in the left side, gross hematuria, proteinuria and secondary arterial hypertension. The diagnosis of compression of the left renal vein was made at the prehospital stage according to MSCT angiography. On the basis of the National Medical Research Center of Sports Agriculture named after. A.N. Bakulev, in the department of arterial pathology, a comprehensive instrumental and laboratory diagnosis was carried out (detailed below), according to which indications for surgical treatment were identified. An operation was performed to transpose the left renal vein into the infrarenal portion of the inferior vena cava from the left thoracophrenolumbotomy approach. According to the results of dynamic postoperative monitoring after the primary operation due to the persistence of symptoms of the disease (lumbar pain, hematuria, moderate restenosis of the left renal vein, retrograde discharge of blood through the left ovarian vein flowing into the venous system of the left kidney, varicose veins of the small pelvis, ovarian cocele according to the results Ultrasound scanning of the renal vein and pelvic veins, MSCT angiography), it was decided to carry out the 2nd stage of surgical treatment in order to normalize the venous outflow from the left ovarian vein into the IVC system, eliminate phlebohypertension of the pelvic veins – an operation of ovarian-iliac anastomosis, which culminated regression of manifestations of residual phlebohypertension.
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About the authors
- Valery S. Arakelyan, Dr. Med. Sci., Professor, Head of the Department of Arterial Pathology Surgery; ORCID
- Vasil G. Papitashvili, Cand. Med. Sci.; ORCID
- Nazim R. Gamzaev, Cand. Med. Sci.; ORCID
- Marta M. Nikoghosyan, Postgraduate; ORCID
- Vladislav L. Khon, Cand. Med. Sci; ORCID
