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H+P

H+P. 77 yo male presented 11/04 with acute L leg ischemia. Underwent embolectomy via L groin exploration and 4-compartment fasciotomy. Post-operative course complicated by HIT, cholecystitis requiring operation, and multiple revisions of fasciotomy wounds/skin grafts.

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H+P

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  1. H+P • 77 yo male presented 11/04 with acute L leg ischemia. Underwent embolectomy via L groin exploration and 4-compartment fasciotomy. Post-operative course complicated by HIT, cholecystitis requiring operation, and multiple revisions of fasciotomy wounds/skin grafts. • Workup for embolic source revealed iliac aneurysms. • PMH: HTN, parkinson’s, DM • Meds: coumadin

  2. Horseshoe Kidney • Occurs in 0.25% of population • Most common of renal fusion abnormalities • M:F 2:1 • Associated with arterial anomalies (60-80%) • Blood supply is asymmetric and segmental with insignificant crossover • Important to preserve individual branches • Cleveland Clinic experience: 67% mortality in those patients requiring dialysis post op • Preoperative imaging important to plan surgical approach

  3. O’Hara et al. JVS 17:940-7, 1993.

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