Spontaneous rupture of a renal artery pseudoaneurysm in a hemodialysis patient A case report

Abstract

Rationale: Renal artery pseudoaneurysm is a rare vascular lesion usually caused by trauma or percutaneous urological procedures. Spontaneous rupture of pseudoaneurysms without predisposing events, especially in hemodialysis patients, has rarely been reported. Patient concerns: A 25-year-old man receiving maintenance hemodialysis visited the emergency room because of sudden severe right flank pain. He had no history of trauma or urological procedures except for a left renal biopsy to diagnose Alport syndrome 10 years prior. Diagnosis: Contrast-enhanced computed tomography revealed a right perirenal hematoma with pseudoaneurysms. Interventions: On renal angiography, multiple pseudoaneurysms were observed in the right renal artery branches and embolization was performed. Outcomes: Post-angiography showed no pseudoaneurysms. His abdominal pain improved, and he was discharged 2 weeks after embolization. Lessons: When maintenance dialysis patients complain of severe abdominal pain, spontaneous rupture of a renal pseudoaneurysm should be considered as a differential diagnosis, even if the patient has no history of trauma or previous urological procedures.