Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Resident : Afshar Ebrahimi
Gender : Male
Age : 46
A 46 y/o male with history of nephrolithotomy presented with gross hematuria.
A contrast enhanced CT section shows a bilobulated structure 36mm in size in lower pole of left kidney that there is no communication with renal calyces and renal vein.
Renal artery pseudoaneurysm
Discussion (Related Text)
Most renal artery pseudoaneurysms result from penetrating injuries, many of which are iatrogenic (e.g., associated with renal biopsy or nephrostomy tube placement. Hypertension and rupture with hemorrhage are the most important complications . Delayed hemorrhage (days to weeks after the initial injury) is not rare and may be heralded by hematuria. CT is highly reliable for diagnosing renal parenchymal and pyelocalyceal injuries, main renal arterial occlusion, and active bleeding. CT is not as accurate for diagnosing branch arterial injuries, including pseudoaneurysm or arteriovenous fistula. In kidneys that develop pseudoaneurysms, the initial CT scan often shows parenchymal laceration without pseudoaneurysm, because acute thrombus may temporarily seal the laceration. Over several days or weeks, clot lysis occurs with subsequent formation of a pseudoaneurysm. Communication with a renal vein branch creates an arteriovenous fistula. A typical pseudoaneurysm enhances in the arterial phase and washes out in the delayed phase.
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