Pulmonary involvement in Gaucher disease

http://dx.doi.org/10.1590/0100-3984.2016.0070 Leonor Garbin Savarese1, Henrique Simão Trad2, Edwaldo Edner Joviliano1, Valdair Francisco Muglia1, Jorge Elias Junior1 1. Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil. 2. CEDIRP – Central de Diagnóstico Ribeirão Preto, Ribeirão Preto, SP, Brazil. Mailing address: Dra. Leonor Garbin Savarese. FMRP-USP. Avenida Bandeirantes, 3900, Monte Alegre. Ribeirão Preto, SP, Brazil, 14049-900. E-mail: [email protected]. Abdominal aortic aneurysm with spontaneous aorto-left renal vein fistula is a rare but well-described clinical entity, usually accompanied by abdominal pain, hematuria, and a nonfunctioning left kidney. In male patients, left varicocele may result from venous overload in the pampiniform plexus via the left gonadal vein. A review of the literature revealed only approximately 30 other reported cases. Aorto-left renal vein fistula is often seen in patients with a retroaortic left renal vein, an anatomical variant present in 1.0% to 2.4% of the population. It has been postulated that the vein is compressed between the pulsating aneurysm and the vertebral bodies, leading to erosion of the vessel wall and fistula formation. Open repair is the recognized method of treating rupture of an abdominal aortic aneurysm into a retroaortic left renal vein. Endovascular treatment is an attractive modality because it is minimally invasive, given its capacity for rapid percutaneous arterial access and graft deployment, as well as, if necessary, balloon occlusion for vascular control, thus minimizing blood loss in comparison with open surgery. To our knowledge, this is the sixth reported case in which endovascular repair of this type of fistula has been attempted.