張朋暉¹、朱懿柏¹、黃一勝^1,2

新光吳火獅紀念醫院 外科部 泌尿科¹

輔仁大學 醫學系²

Peng-Hui Chang¹, Yi-Bo Chu¹, Thomas I.S. Hwang^1,2

Division of Urology, Department of Surgery, Shin Kong WHS Memorial Hospital¹

School of Medicine, Fu-Jen Catholic University²

 

Superior mesenteric artery (SMA) injury during left nephrectomy is a rarely reported complication. Herein, we report a 68 years old male who came to our emergency room with progressive intermittent left abdominal pain for days. Lab study showed leukocytosis and elevated AST level. A computed tomography scan with contrast showed a locally invasive renal tumor up to 9 cm with clinical stage T4N0M0. Laparoscopic left radical nephrectomy was arranged later. During the procedure, inadvertent injury to the SMA was noted. Vascular surgeon was consulted and we converted to open surgery. Enterolysis and an end to side repair of SMA were done smoothly. Postoperative fasting was given for a period and diet was then given gradually. The patient recovered gradually and then discharged smoothly. The literature was reviewed and discussed.