A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)

Macroscopic hematuria regards the 4% to 20% of all urological visits. Renal artery aneurysms (RAAs) are detected in approximately 0.01%–1% of the general population, while intraparenchymal renal artery aneurysms (IPRAAs) are even more rarely detected in less than 10% of patients with RAAs. We present a case of a 58-year-old woman that came into the emergency room (ER) complaining of a gross hematuria during the last four days. Although in the ER room the first urine sample was clear after a cough episode, a severe gross hematuria began which led to a hemodynamically unstable patient. Finally, a radical nephrectomy was performed, and an IPRAA was the final diagnosis. A cough deteriorating hematuria could be attributed to a ruptured intraparenchymal renal artery aneurysm, which even though constitutes a rare entity, it is a life-threatening medical emergency.

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Imaging of a Renal Artery Aneurysm Detected Incidentally on Ultrasonography

Case Reports in Radiology ◽

10.1155/2014/375805 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Vasileios Rafailidis ◽

Anna Gavriilidou ◽

Christos Liouliakis ◽

Maria Poultsaki ◽

Triantafyllos Theodoridis ◽

...

Keyword(s):

General Population ◽

Renal Artery ◽

Artery Aneurysm ◽

Renal Artery Aneurysm ◽

Rare Entity ◽

Life Threatening ◽

The Right

Renal artery aneurysms occur with a frequency of less than 1% of the general population. Even if they are usually asymptomatic and incidentally found, they can be complicated with life-threatening conditions like rupture, thrombosis, embolism, or hypertension. Thus, once diagnosed, they should be fully evaluated with further imaging and treated when indicated. We present the case of a patient who was referred for ultrasonography for an unrelated reason. The examination demonstrated a hyperechoic focus near the right kidney. Further imaging workup with MDCT established the diagnosis of a right renal artery aneurysm which was saccular in shape and peripherally calcified. This ring-like calcification was also visible in a KUB radiography which was also performed. After presenting the case, various aspects of this rare entity are discussed.

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Percutaneous intervention treatment of giant extrarenal aneurysm arteriovenous fistula

Tạp chí Phẫu thuật Tim mạch và Lồng ngực Việt Nam ◽

10.47972/vjcts.v33i.561 ◽

2021 ◽

Vol 33 ◽

pp. 32-37

Author(s):

Nguyen The Huy ◽

Phan Thao Nguyen ◽

Tran Thuy Nguyen ◽

Le Ngoc Thanh

Keyword(s):

Renal Artery ◽

Arteriovenous Fistula ◽

Artery Aneurysm ◽

Percutaneous Intervention ◽

High Flow ◽

Renal Artery Aneurysm ◽

Gross Hematuria ◽

Renal Arteriovenous Fistula ◽

Intervention Treatment ◽

Rare Case Report

Objective: Anteriovenous fistula is a high-flow vascular malformation. Anteriovenous fistula is characterized by a direct connection between an artery and a vein without the presence of a nidus (network of arterial and venous channels). Renal artery aneurysm concomitant with a renal arteriovenous fistula is extremely rare. Case report: We reported the case of a 45-year-old female who has giant renal artery aneurysm combined with high-flow RAVF who presented with gross hematuria. The patient’s embolization of a giant extrarenal aneurism arteriovenous fistula was successfully treated using specialized coils and plug device. Conclusions: Renal arteriovenous fistula is a disease that can lead to serious complications. Treatment of this condition should be initiated promptly after diagnosis. Embolization endovascular is a feasible, efficient and safe method which can maximally retain normal renal function.

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