PMC6202614_01
Ultrasonographic images of the aneurysm: A. The aneurysm in the B-mode presentation, B. Color-doppler revealing the flow within the structure, the arrow indicates fluid within Gerota's fascia.
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The control abdominal ultrasound revealed an increase in the size of the previously described lesion up to 4.8 cm (Figure 1A). Color-doppler imaging performed at that moment revealed turbulent flow within the lesion, and a fluid collection within Gerota's fascia was found (Figure 1B).
Images of the aneurysm: A. Angio-CT (Computed Tomography Angiography) scan of the aneurysm (bold arrow). Fluid in Gerota's fascia (thin arrow). B. Three-dimensional reconstruction of the aneurysm (arrow). C. An intraoperative image of the exposed aneurysm (arrow). D. An intraoperative image following the excision of the aneurysm with visible polypropylene suture lines (arrow).
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CT confirmed the diagnosis of the aneurysm and the fluid collection around the right kidney (Figure 2A, 2B). The hilum of the kidney and the aneurysm were exposed (Figure 2C). Since it was adjacent to large veins and the kidney parenchyma, in order to avoid bleeding, most of the aneurysm's wall was excised and the remaining part of the aneurysm was sutured using 4/0 polypropylene sutures (Figure 2D).