PMC3350148_01
CT 3D reconstruction of the monolateral dual kidney transplantation implanted on the right iliac vessels.
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fig1
After revascularization of the implanted graft, the right kidney was transplanted by anastomosing the renal vessels to the external iliac vessels in end-to-side fashion (Figure 1).
CT scan showing the relationship among the transplanted kidneys (k), the lymphocele (*), the renal artery (a) and vein (v), and the dilated ureter (u).
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fig2
Urgent ultrasound examination (US) and subsequent CT scan showed a complex fluid collection of 11 cm diameter in the right iliac fossa engulfing both grafts, associated with a mild hydroureteronephrosis of the superior kidney (Figure 2).
The simultaneous visualization of the same region in conventional B mode and contrast-enhanced mode allowed the identification of ureters. Left side: B mode ultrasound visualization of renal artery (a) vein (v) within the lymphocele (L) and bladder (B). Right side: contrast-enhanced ultrasound visualization of the same region showing the bladder (B) and the ureter (arrows) filled by contrast agent.
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fig3
Renal function improved after percutaneous drainage and subsequent marsupialization of lymphocele.
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fig4
A steady recovery of renal function with decreasing serum creatinine and reduction of the inferior limb edema occurred in the following days (Figure 4).