Avulsion of the left renal artery following blunt abdominal trauma in a dog

Abstract

A two-year-old, male, crossbreed dog was presented three days after being involved in a motor vehicle accident. Survey radiographs showed multiple pelvic fractures and poor intraperitoneal and retroperitoneal contrast. Ultrasound indicated the left kidney to be hypoperfused, and a thrombus was visible at the origin of the left renal artery. Ultrasound-guided fine needle aspiration confirmed that free fluid visible in the retroperitoneal and peritoneal spaces was blood. No improvement was seen in the renal perfusion over a 43 hour period, and the intestinal hypomotility worsened over this time. The haemoperitoneum and the haemoretroperitoneum both resolved ultrasonographically within this 43 hour period. Surgery confirmed an avulsion of the left renal artery approximately 10 mm from its origin on the aorta and an avulsion of the left ureter at the ureteropelvic junction. An ureteronephrectomy was performed on the left kidney and the dog recovered uneventfully.

Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review

“…In particular, on postcontrast MDCT, it is possible to identify areas of absence of parenchymal enhancement at the level of the organ's rupture. Organ avulsion with secondary extra‐parenchymal vessel rupture has also been reported in small animals …”

“…Organ avulsion with secondary extra-parenchymal vessel rupture has also been reported in small animals. 105…”

The impact of surgical timing and intervention on outcome in traumatized dogs and cats

“…Many injuries can occur after blunt trauma including diaphragmatic hernia (DH), hemoperitoneum, and appendicular or axial fractures . The forces created during these injuries can cause devastating injuries and death, with an overall mortality rate of 10%–12% in canine patients .…”

“…Blunt or penetrating injuries associated with motor vehicle accidents are the number 1 etiology when traumatic hemoperitoneum does occur . Four articles pertaining directly to traumatic hemoperitoneum were found, including 2 case reports and 2 retrospective studies, the largest of which describes 83 dogs with 6 cases due to trauma . In 1 review, arresting ongoing hemorrhage is fourth on a list of initial stabilization goals and can in some cases be managed without the need for surgery (abdominal counterpressure techniques).…”

“…Two case reports of traumatic hemoperitoneum report surgery days after the traumatic event. Surgery was performed in these cases not due to life‐threatening hemorrhage but for management of concurrent injuries …”