COARCTATION OF THE ABDOMINAL-AORTA WITH LEFT RENAL-ARTERY AND SPLENICARTERY ANEURYSMS

Both coarctation of the abdominal aorta, and splenic artery aneurysm r eside in the hilus, a rare but extremely important pathological condit ion. Herein a 36-year-old woman hospitalized for uncontrolled hyperten sion is presented. Aortography demonstrated segmental abdominal aortic coarctation with left renal artery and splenic artery aneurysms. Medi cal control of hpertension was not possible and thoracoabdominal bypas s with a prosthetic graft was undertaken. Left renal artery aneurysm w as resected and aorto-renal saphenous vein bypass was performed. But s plenic artery aneurysm was left in situ because it was asymptomatic an d less than 2 cm in diameter. Postoperatively the patient was normoten sive. Although the pathogenesis of such lesions remain unknown, it may be to congenital or related medial degeneration as demonstrated histo logically.