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February 1965

Acute Bilateral Renal Artery Occlusion in Man: Report of a Case Relieved Surgically 14 Hours After Occlusion With Survival

Author Affiliations

From the Surgical Service of the San Francisco Veterans Administration Hospital and the University of California School of Medicine. Consultant In Surgery, San Francisco Veterans Administration, Assistant Clinical Professor in Surgery, University of California School of Medicine (Dr. Erskine); and Chief of Surgery, San Francisco, Veterans Administration Hospital, Assistant Clinical Professor of California School of Medicine (Dr. Blaisdell).

Arch Surg. 1965;90(2):247-252. doi:10.1001/archsurg.1965.01320080071016

Introduction  EXTENSIVE SURGICAL procedures on the abdominal aorta are now common. Renal complications following such surgery occasionally occur. Many cases of oliguria result from either periods of surgical shock associated with the operative procedure or from poorly understood reactions in the kidneys to the cross clamping of the aorta below the renal arteries. Considerable attention has been given to these problems of acute tubular damage with associated oliguria or anuria during the last few years and progress has been made in supporting these patients during the phase of renal impairment with rigid medical management and often dialysis. Most cases of anuria occurring immediately after surgery can be related to hypotension or surgical shock. Others previously thought to be due to the altered physiology involved in cross clamping the infrarenal aorta may actually be due to bilateral renal artery occlusions or of most of the major branches. An accurate and immediate

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