002K Post Biopsy Pseudoaneurysm Hemorrhage Subcapsular Hematoma Post Embolisation
46 yo female with
PMH of
T2DM, HTN,
discoid lupus,
peripheral vascular disease and
PSUD (cocaine + alcohol) w
pw
oliguric renal failure requiring initiation of HD.
complicated by MSSA bacteremia from
right toe osteomyelitis which was further
complicated by
RUE abscess.
US – Increased Echogenicity
Biopsy Result
Kidney biopsy which preliminarily is showing 60% sclerosis with evidence of chronic active interstitial nephritis
Post Biopsy Non Contrast CT
CT Shows Active Bleeding and Pseudoaneurysms
Post Biopsy Arterial Phase CT
Post Biopsy Portal Venous Phase CT
IR Angiography Multiple PSA’s and Active Bleeding
Sub-selective IR Angiography Pseudoaneurysm
IR Angiography Embolizations
Final Result
46 year old female with discoid lupus erythematosus and renal failure. Selective angiography injecting into the right renal artery post biopsy shows findings suggestive of pseudo-aneurysms and in a segmental artery in the lower pole Sub-selective catheterization with embolisation of 3 pseudoaneurysms and one active bleed
Ashley Davidoff TheCommonVein.net
Renal angiography demonstrates pseudoaneurysms involving three
subsegmental branches of the right renal artery and active contrast
extravasation from a fourth subsegmental branch. Selective catheterization
and coil embolization performed of each subsegmental branch to stasis.
Post embolization right renal angiography showed resolution of the
pseudoaneurysms and areas of active contrast extravasation. Mass effect
upon the right kidney seen from known perinephric hematoma.