Severe haemorrhage from a lumbar artery as a complication of percutaneous renal biopsy

Jamison, M. H.; Coward, R. A.

doi:10.1136/pgmj.61.711.69

Cited by 21 publications

(24 citation statements)

References 4 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Less common complications include arteriovenous fistula (AVF), colonic perforation and accidental biopsy of tissues: liver, spleen, muscle, lymph node, blood vessels, and adrenal [2]. Various rare complications, usually restricted to case reports, are perirenal urinoma, laceration of mesenteric artery, haemorrhage from lumbar artery, traumatic aneurysm of renal artery, seeding of adenocarcinoma, perforation of colon [13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Safety of kidney biopsy in elderly: a prospective study

et al. 2006

View full text Add to dashboard Cite

Kidney biopsy plays an important role in the diagnosis and management of several renal diseases. There is a general reluctance to perform kidney biopsy in elderly due to fear of complications. There is no prospective head to head trial comparing complications of percutaneous kidney biopsy in elderly versus young. This prospective study was undertaken to know the frequency and type of biopsy related complications in elderly. Biopsy was performed using a spring loaded automatic 16 G biopsy gun. Post-biopsy, patients were confined to bed rest for 24 h. A record of intraprocedural problems and post-procedural complications was kept. A total of 210 native kidney biopsies were done of which 26 were performed in elderly patients (61-78 years). Co-morbid conditions were present in 17 patients, some having more than one, hypertension (11), diabetes mellitus (5), chronic obstructive airway disease (6), interstitial lung disease (2) and coronary artery disease (2). Mean serum creatinine was 5.6 mg/dl (range 0.8-14.1 mg/dl). Pre-biopsy dialysis was given to 10 patients. Adequate tissue for histopathological diagnosis was seen in 24 out of 26 biopsies. In two elderly patients biopsy had to be abandoned though indicated due to inability to hold the breath because of underlying lung and cardiac disease. Clinico-pathologic discorrelation was seen in eight patients. Incidence of gross hematuria was more in elderly than in young (4/26 vs. 7/184 P<0.01). Hematuria subsided within 1-2 days in three, one had persistent hematuria for 1 week. Other complications viz. gross hematuria with need of blood transfusions or hemodynamic compromise (0/26 vs. 4/184), perinephric hematoma (0/26 vs. 1/184) and need of intervention (0/26 vs. 1/184) were not higher in the elderly. We conclude that the standard precautions kidney biopsy in elderly is a safe procedure.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety of kidney biopsy in elderly: a prospective study

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Injuries of extra-renal arteries by biopsy needles are very rare. We found only four cases of lumbar artery injury following renal biopsy that have been reported in literature [4][5][6][7]. Injury to mesenteric artery, [8] intercostal artery [9] and abdominal aorta [10] are the other solitary case reports of biopsy related complications.…”

Section: Discussionmentioning

confidence: 99%

Lumbar Artery Embolization for Control of Bleeding after Percutaneous Renal Biopsy

AM¹,

BV²

2016

Med Surg Urol

View full text Add to dashboard Cite

“…It can also represent a complication arising in connection with structural changes in the arterial wall, aneurysm rupture, and local inflammation. Only a few cases of LA injury with subsequent massive retroperitoneal bleeding caused by a renal biopsy have been reported until today [2][3][4][5] . Suspicion for iatrogenic artery injury with active bleeding is clear indication for CT an- giography and method of choice for treatment is endovascular embolization [5] .…”

Section: Discussionmentioning

confidence: 99%

“…The most significant complication of this procedure is vascular damage with subsequent bleeding [1] . Laceration of the lumbar artery (LA) is a rare, but serious damage, causing severe retroperitoneal haemorrhage [2][3][4][5] . There are typically 4 LAs on each side, arranged similarly to the intercostal arteries.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Late Rupture of Lumbar Artery as an Unusual Complication after Renal Biopsy - Case Report

et al. 2016

View full text Add to dashboard Cite

The most serious complication of renal biopsy is vascular damage with subsequent haemorrhage. To our knowledge, we present a first ever case of lumbar artery (LA) rupture accompanied by massive retroperitoneal bleeding, which developed after a significant amount of time following the biopsy itself. In a 63-year-old Caucasian female patient, a percutaneous left kidney biopsy was performed under continuous ultrasound guidance. On the fourteenth day after the procedure, she was examined for a sudden onset of left lumbar region pain. Computed tomography angiography showed a large retroperitoneal hematoma with active bleeding from the fourth left LA. Successful endovascular superselective embolization was performed immediately. The predisposing factor for the late haemorrhage could have been anticoagulation therapy, renal insufficiency and older age. Our case report highlights the need for caution, especially when performing kidney biopsy in a group of high-risk patients, particularly if they are indicated for subsequent anticoagulant therapy.

show abstract

Severe haemorrhage from a lumbar artery as a complication of percutaneous renal biopsy

Abstract: Summary:A patient is described with severe haemorrhage from a lumbar artery foflowing percutaneous renal biopsy. The exact source of haemorrhage in this previously unreported complication proved difficult to locate even at surgical exploration.

Cited by 21 publications

References 4 publications

Safety of kidney biopsy in elderly: a prospective study

Safety of kidney biopsy in elderly: a prospective study

Lumbar Artery Embolization for Control of Bleeding after Percutaneous Renal Biopsy

Late Rupture of Lumbar Artery as an Unusual Complication after Renal Biopsy - Case Report

Contact Info

Product

Resources

About