Renal artery pseudoaneurysm

• Main Authors: Luiz Inácio Roman, Cauana Fabrício Efel, Victória Teles França, Carolina Meert Merten, Claus Dieter Dummer
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Nefrologia
• Series: Brazilian Journal of Nephrology
• Subjects: hematuria; image-guided biopsy; renal artery
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002017000400458&lng=en&tlng=en

Abstract The renal artery pseudoaneurysm embody a rare vascular complication coming of percutaneous procedures, renal biopsy, nephrectomy, penetrating traumas and more rarely blunt traumas. The clinical can be vary according the patient, the haematuria is the symptom more commom. Is necessary a high level of clinical suspicion for your diagnosis, this can be elucidated by through complementary exams as the eco-color Doppler and the computed tomography scan (CT). This report is a case of a patient submitted a right percutaneous renal biopsy and that, after the procedure started with macroscopic haematuria, urinary tenesmus and hypogastric pain. The diagnosis of pseudoaneurysm was given after one week of evolution when the patient was hospitalized because gross haematuria, tachycardia, hypotension and hypochondrium pain. In the angiotomography revealed a focal dilation of the accessory right renal inferior polar artery, dilation of renal pelvis and all the ureteral course with presence hyperdenso material (clots) inside the middle third of the ureter. The treatment for the majority of this cases are conservative, through arterial embolization, indicated for thouse of smaller dimensions in patients who are hemodynamically stable. However, it was decided by clinical treatment with aminocaproic acid 1 g, according to previous studies for therapy of haematuria. The patient received discharge without evidence of macroscopic haematuria and with normal renal ultrasound, following ambulatory care.