Intrarenal post-traumatic pseudoaneurysm-USG colour Doppler diagnosis: a case report with review of literature

Abstract

Renal artery pseudoaneurysm, although a well-known complication in patients after penetrating trauma or iatrogenic injury, has rarely been described after blunt torso trauma. A 22-year-old man suffered an accident while on a motorcycle. Upon arrival in the Emergency Room, the patient was unconscious, hypotensive and had hematuria. Initial investigations revealed a fractured shaft of the right femur, multiple rib fractures with hemothorax, extradural haematoma on the right side and a laceration in the right kidney. After the evacuation of intracranial bleed, the patient was managed conservatively. The patient recovered well and was discharged on the 15th post-trauma day. The patient was again present in the emergency room after 6 weeks with 1-week history of gross hematuria. Ultrasonography revealed an anechoic lesion in the right kidney with pulsatile flow on colour Doppler. Further investigation with computed tomography renal angiography was done, which confirmed the pseudoaneurysm of a branch of renal artery. The patient was referred to a higher centre where he was successfully managed with selective arterial coil embolisation.

Contrast-enhanced ultrasonography revealed active thoracic bleeding

“…Previous reports showed that color Doppler images can demonstrate a swirling flow or turbulence at the bleeding site [4][5][6]. However, CEUS with Sonazoid TM seems to be more sensitive than color Doppler US in detecting the Fig.…”

Intrarenal pseudoaneurysm with renal cell carcinoma

“…Angiography is the most specifi c procedure for diagnosing pseudoaneurysms, and CT angiography has been used as an alternative to conventional angiography in recent years. 4,5 To our knowledge, use of Levovist as a diagnostic material has not Introduction Renal cell carcinoma (RCC) is the most common cancer of the kidney. This neoplasm can be characterized by varied and obscure clinical and radiological manifestations, which may include multifocal RCC, RCC with central necrosis, multiseptated cystic carcinoma simulating a complex renal cyst, and an arteriovenous fi stula caused by RCC.…”

Renal artery pseudoaneurysm after blunt renal trauma: report on three cases and review of the literature

“…The first case of renal artery pseudoaneurysm was described by Rouppe (1770, apud Rashid, 2007), 5,6 who reported the demise of a sailor who fell on his right flank.…”