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History & Physical

History & Physical. 54 yo female initially presented 2004 with vague abdominal pain who underwent abdominal ultrasound documenting R renal artery aneurysm. Has been followed over the course of 2 years now with increasing size. Denies R flank pain, hematuria. PMH: hemachromatosis

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History & Physical

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  1. History & Physical • 54 yo female initially presented 2004 with vague abdominal pain who underwent abdominal ultrasound documenting R renal artery aneurysm. Has been followed over the course of 2 years now with increasing size. Denies R flank pain, hematuria. • PMH: hemachromatosis • Exam: no abdominal bruits, normal peripheral pulses • Labs: Creat=1.0

  2. R kidney removed from Gerota’s fascia Ureter dissected free

  3. Kocher maneuver frees up IVC IVC R ovarian vein ligated R renal vein Ureter dissected free

  4. ureter After artery and vein clamped and ligated off aorta and IVC, kidney brought up to ice bucket Bifurcation of main R renal artery with thin walled-aneurysm

  5. R main renal artery Renal vein transected

  6. Superior & inferior renal arteries transected, then syndactylized

  7. Syndactylized branches R renal artery R hypogastric artery

  8. 2cm R renal artery aneurysm

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