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Doctor's Information

Name : Farshid
Family : Mohebi
Affiliation :Zahedan Radiology Department,imam Ali Hospital,
Academic Degree : Asssiatant professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Mohsen Hasanzadeh

Case Section

Interventional Radiology

Patient's Information

Gender : Male
Age : 38

Clinical Summary

38 y/o man after renal surgry

Imaging Findings

small size vascular outpouching with early venus filling is seen

Differential Diagnosis

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Final Diagnosis

Iatrogenic Renal AVF

Discussion (Related Text)

Renal calculi that are not suitable for lithotripsy or retrograde removal may be fragmented and extracted via a percutaneous route. To facilitate calculus removal, puncture is performed into the calyx containing the stone. This type of access is challenging, particularly when stones are large and obstructive. Procedures may be protracted, requiring repeated punctures with extensive wire manipulation. In this case, the sheared tip of a guide wire ultimately appeared to facilitate a communication between artery and vein, which led to continued perinephric hemorrhage. This injury was also likely exacerbated by stone extraction, which required insertion and manipulation of large catheters (30 French). Protracted bleeding after renal access and stone extraction is unusual and typically indicates arterial injury, either pseudoaneurysm or arteriovenous fistula.

References

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