Introduction. The renal artery and segmental renal artery pseudoaneurysm is a
rare and usually asymptomatic vascular lesion which in most of the cases
thrombose spontaneously, but at same time it can be a source of
life-threatening hemorrhage and shock. Today, these pseudoaneurysms are
discovered with increasing frequency due to unrelated abdominal imaging or
on screening work-ups for hypertension, as well as widespread use of
angiography. Typically, they are seen in patients after trauma,
inflammation, or renal surgery or biopsy. Case outline. In our case, a
52-year-old male patient with no prior history of surgery, significant
abdominal trauma and systemic disease, presented with left flank pain and
signs of hypovolemic shock that manifested before the admission in the
surgical emergency room. The CT scan promptly demonstrated rupture of large
retroperitoneal hematoma with the massive intraperitoneal hemorrhage. The
angiography confirmed the rupture of the renal artery pseudoaneurysm. The
patient had the urgent operation. A life-saving nephrectomy was performed
while intraperitoneal hemorrhage and retroperitoneal hematoma was evacuated.
The fourteen days after surgery the patient was discharged fully recovered,
with normal diuresis and serum levels of creatinine and urea within
referential values. During the period of hospitalization, he was diagnosed
and treated hypertension. Conclusion. Rupture of pseudoaneurysms with the
following hemorrhage into the intraperitoneal cavity and retroperitoneum is
a life-threatening condition, as proven with this case in which hypovolemic
shock manifested before the admission. We would like to highlight the
importance of high blood-pressure control and the importance of regular
check-ups.
Renal artery pseudoaneurysm after blunt abdominal trauma
