METHODS: A young man presented with acute severe bilateral testicular pain radiating to the back. Clinical and radiological workup showed bilateral external iliac artery pseudoaneurysms, which caused bilateral ureterohydronephrosis due to urinary obstruction with subsequent renal failure. Management included immediate bilateral external iliac artery endovascular repair and bilateral ureterolysis using a retroperitoneal approach, with resolution of the obstruction and successful endovascular treatment of both pseudoaneurysms. The only identifiable risk factor for cardiovascular disease was cocaine addiction.
CONCLUSIONS: This case highlights an unusual and severe clinical presentation of bilateral EIA pseudoaneurysms causing bilateral ureterohydronephrosis and subsequent renal failure. Awareness of this condition may help avoid misdiagnosis and delayed management, which is of utmost importance for a favorable outcome.
方法:一名年轻男子表现为向背部放射的急性重度双侧睾丸疼痛。临床和放射学检查显示双侧髂外动脉假性动脉瘤,由于尿路梗阻导致双侧输尿管积水并随后出现肾功能衰竭。治疗包括立即双侧髂外动脉腔内修复术和使用腹膜后入路的双侧输尿管溶解术,随着阻塞的解决和两个假性动脉瘤的成功血管内治疗。唯一可识别的心血管疾病危险因素是可卡因成瘾。
结论:该病例突出了双侧EIA假性动脉瘤的异常和严重临床表现,导致双侧输尿管肾积水和随后的肾功能衰竭。意识到这种情况可能有助于避免误诊和延迟管理,这对有利的结果至关重要。