Renal fusion over the aorta (horseshoe kidney) is another anomaly that creates intraoperative problems. In addition to the aberrant circulation patterns, the isthmus of the fused kidney lies over the aorta. The isthmus usually contains a significant amount of the collecting system and therefore can not be divided to facilitate exposure.
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Anomalies in the vena cava drainage are important findings on CT images. A preoperative venogram demonstrates a duplicated inferior vena cava. Preoperative knowledge of these entities prevents inadvertent injury during surgery during dissection or clamping.
References:
Richardson JW, Greenfield LJ: Natural history and management of iliac
aneurysms. J.Vasc.Surg. 1988;8:165-171
Santilli SM, Warning SE., Lee ES: Expansion Rates and Outcomes for Iliac
Artery Aneurysms.
J.Vasc Surg 1999;2000:31:114-21.
Salaman RA, Shandall A, Morgan RH, et al. Intravenous digital subtraction
angiography versus computed tomography in the assessment of abdominal
aortic aneurysms.
BR J Surg 1994;81:661-3.
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