Renal artery pseudoaneurysm formation and rupture induced by renal abscess: A case report

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Abstract

Severe consequences can ensue from the rupture and hemorrhage of a renal artery pseudoaneurysm, necessitating immediate intervention upon detection. To date, no reports exist on the development of renal artery pseudoaneurysms as a result of renal abscesses. This document introduces the first reported case of this occurrence.

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Renal pseudoaneurysm: an overview.

Brian J. Lee, Shyuan Ngo, Mark Gonzalgo (2010)

Renal pseudoaneurysm is a rare vascular lesion that arises when an arterial injury within the kidney leads to contained hemorrhage. The associated hematoma forms outside the arterial wall and is typically surrounded by a layer of fibrous inflammatory tissue and blood clot. These lesions are unstable and their rupture can lead to life-threatening hemorrhage. Renal pseudoaneurysm has been reported to occur in various clinical scenarios, including after renal trauma, surgery and percutaneous procedures, as well as inflammatory and neoplastic processes within the kidney. Endovascular selective angioembolization is the mainstay of treatment, although surgery might be indicated when hemostasis and repair of the arterial wall defect are required. Percutaneous ultrasound-guided embolization is an additional option for patients with unfavorable vascular anatomy, or who cannot tolerate or have contraindications to the use of intravenous contrast agents. Some evidence suggests that these lesions can regress without intervention, although observation alone is not recommended as a management strategy in the vast majority of patients owing to the high risk of rupture. Evaluation and management of patients with renal pseudoaneurysm must take into account each individual's circumstances, due to the difficulty of accurately predicting the probability of spontaneous resolution or rupture.

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Renal artery pseudoaneurysm following laparoscopic partial nephrectomy.

Dinesh Singh, Inderbir Gill (2005)

We describe the presentation, evaluation and management of hemorrhage due to renal artery pseudoaneurysm following laparoscopic partial nephrectomy. Of the 345 laparoscopic partial nephrectomies performed by us during a 5-year period 6 patients (1.7%) had postoperative hemorrhage from a renal artery pseudoaneurysm. Patient charts were reviewed to identify pertinent preoperative, intraoperative and postoperative data. Median tumor size was 3.5 cm (range 2.2 to 5), intraoperative blood loss was 175 cc (range 50 to 500), warm ischemia time was 32 minutes (range 30 to 45) and operative time was 3.8 hours (range 2.5 to 5). The mean percent of kidney excised was 31% and pelvicaliceal system entry was suture repaired in all 6 patients. No patient required blood transfusion perioperatively. Average hospital stay was 3.4 days (range 2.5 to 6). Delayed postoperative hemorrhage occurred at a median of 12 days (range 8 to 15). Angiography revealed a renal artery pseudoaneurysm most commonly at a third or fourth order branch (4 and 2 patients, respectively). Percutaneous embolization was successful in each patient. Renal artery pseudoaneurysm is an uncommon complication following laparoscopic partial nephrectomy. These patients often present in delayed fashion. Selective angiographic embolization is the initial treatment of choice.

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Coil embolization of renal artery bifurcation and branch aneurysms with flow preservation.

Hanfei Tang, Xiao Tang, Weiguo Fu … (2018)

Coil embolization is one of the most common endovascular approaches to treatment of renal artery aneurysms (RAAs). The purpose of this retrospective study was to compare complications, mortality, and morbidity associated with sac packing, coil trapping, and inflow occlusion.

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Author and article information

Contributors

Fubing Chen

Journal

Journal ID (nlm-ta): Urol Case Rep

Journal ID (iso-abbrev): Urol Case Rep

Title: Urology Case Reports

Publisher: Elsevier

ISSN (Electronic): 2214-4420

Publication date PMC-release: 31 August 2023

Publication date Collection: November 2023

Publication date (Electronic): 31 August 2023

Volume: 51

Electronic Location Identifier: 102547

Affiliations

[1]Department of Urology, The First People's Hospital of Suining, Suining, 629000, China

Author notes

[∗ ]Corresponding author. 1264326349@ 123456qq.com

Article

Publisher Item ID: S2214-4420(23)00233-4 Publisher ID: 102547

DOI: 10.1016/j.eucr.2023.102547

PMC ID: 10493886

PubMed ID: 37701418

SO-VID: c73506a3-44d2-440a-bc21-220bf33d1dfe

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 29 July 2023

Date revision received : 25 August 2023

Date accepted : 27 August 2023

Renal artery pseudoaneurysm formation and rupture induced by renal abscess: A case report

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Abstract

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Most cited references 17

Renal pseudoaneurysm: an overview.

Renal artery pseudoaneurysm following laparoscopic partial nephrectomy.

Coil embolization of renal artery bifurcation and branch aneurysms with flow preservation.

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