Management of Severe Bleeding Following Partial Nephrectomy With Selective Renal Artery Embolization: A Case Report

Abstract

KEYWORDS: Partial nephrectomy; Embolization; Renal artery bleeding; von Hippel-Lindau syndrome.We describe the immediate and short-term effects of selective transcatheter embolization of the renal artery used to treat severe bleeding that followed nephron-sparing surgery. The patient was a 27-year-old male with renal cell carcinoma that was associated with von Hippel Lindau syndrome. Partial nephrectomy was performed to remove a tumor mass. On the 7th postoperative day, the patient demonstrated macrohematuria, strong flank pain, a significant drop in hemoglobin level, and an increase in creatinine level. CT scan indicated the presence of hemorrhagic blots in the left renal pelvis and left ureter and disorganization of the caliceal group on the upper pole. Selective embolization was performed. Three months later, creatinine level measurements (1.4 mg/dL) showed relatively good function of the remaining kidney. A MAG3 nephrogram revealed a 65-35 split function.The immediate radiologic and clinical success of selective transcatheter embolization in this complication of partial nephrectomy is discussed.