Spontaneous rupture of intrarenal arterial aneurysm.

Abstract

Spontaneous rupture of a non-calcified intrarenal aneurysm is usually fatal. This case report is of an unusual presentation of this uncommon condition, and the patient remained in good health after treatment.In a series of 100 non-calcified renal artery aneurysms 25 % ruptured, and 83 % of these ruptured aneurysms were fatal (Ippolito and LeVeen, 1960). Smith and Hinman (1967) stated that 17% of all renal aneurysms were intrarenal and 20% of reported intrarenal aneurysms were associated with fatal rupture. Most renal aneurysms are small and asymptomatic. Larger ones may present with renal pain, haematuria, hypertension, and, rarely, a pulsatile renal mass. Case ReportThe patient, a woman aged 72, had had seven uncomplicated pregnancies and had reached the menopause at 53 years. She was referred in October 1967 with frequency, backache, and urgency of micturition of six weeks' duration. Two years previously she had had cystitis. Clinical examinaton showed no abnormality apart from a blood pressure of 190/110 mm Hg. The blood urea, haemoglobin, and urine cytological findings were normal. No abnormality was found at cystoscopy. Bacillus proteus was cultured from the midstream urine and was eradicated by antibiotic treatment. The intravenous pyelogram showed a space-ccupying lesion in the lower pole of the right kidney (Fig.