Sténose de l'artère rénale droite par les piliers du diaphragme. A propos d'un cas

We present one case of arterial hypertension that had rapidly developed in a 23-year-old patient. Arteriography demonstrates a light stenosis of the root of the right renal artery and an obstruction of the superior mesenteric artery. After an attempt of intraluminal dilatation had failed, we decided to carry out double revascularization with a venous graft. Postoperative control arteriography demonstrated early thrombosis in both grafts. Our second operation directly approached the lesion on the root of the renal artery, which was stenosed by muscle fibers from the right column of the diaphragm muscle. The resection of these fibers released the renal artery, which was otherwise normal, as was confirmed by the postoperative arteriogram. In a second part, we discuss the etiology of this double stenosis and our surgical strategy.