Intrarenal artery pseudoaneurysm after blunt abdominal trauma: a case report of successful superselective angioembolization

Abstract

Renal artery pseudoaneurysm is a very rare complication after blunt trauma injury. We report on a case of a 54-year-old man admitted to our hospital for right flank pain and gross hematuria, 5 days after blunt abdominal trauma. The diagnosis of interlobar renal pseudoaneurysm was established by a computed tomography scan and confirmed by angiography. Successful superselective angioembolization was performed. This radiographic intervention is an effective and minimally invasive technique to stop active bleeding from renal artery pseudoaneurysms, when patients are hemodynamically stable and where technically feasible. A review of the literature was carried out.

Kidney and uro-trauma: WSES-AAST guidelines

“…Indications to angiography and eventual selective angioembolization include arterial contrast extravasation on CT-scan in hemodynamically stable or transient responder patients [170, 181–188], gross non-self-limiting hematuria [188, 189], arteriovenous fistula [181, 188], Pseudoaneurysm (PSA) [188, 190] extended perirenal hematoma [184, 186, 191, 192] and progressive decrease in hemoglobin concentration during NOM [185, 188]. Disrupted Gerota’s fascia associated with contrast extravasation is suggested to increase the need for AE [192].…”

Management of high-grade pediatric renal trauma in tertiary referral hospital in Indonesia: A case series and literature review

“…Pseudoaneurysms are rare and may present as secondary hematuria following renal trauma. This risk is highest in patients with higher-grade trauma who are managed conservatively [ 18 , 19 ]. Further evaluation may include renal angiography with selective angioinfarction of the bleeding site to minimize radiation exposure.…”

Percutaneous transcatheter super-selective renal arterial embolization with N-butyl cyanoacrylate for iatrogenic renal hemorrhage

“…A variety of embolic agents, including gelatin sponge pieces, polyvinyl alcohol particles, microcoils, and liquid glue, have been used in SRAE for renal hemorrhage, all with various pros and cons. 5 , 6 , 8 , 22 , 23 The advantages of using a gelatin sponge include cost-effectiveness and a relatively low risk of tissue necrosis, whereas the risk of recanalization is thought to be high. Polyvinyl alcohol particles are associated with an increased risk of renal infarction because they cannot be visualized or precisely deposited and may reflux to non-target arteries.…”