Embolization of renal-artery pseudoaneurysm after laparoscopic partial nephrectomy for angiomyolipoma: case report and literature review

BACKGROUND: Renal-artery pseudoaneurysm (RAP) is a well-described complication of trauma or percutaneous urologic procedures. Delayed bleeding from an RAP is rare after partial nephrectomy. CASE REPORT: We present a 49-year-old woman who, 24 days after undergoing a laparoscopic right partial nephrectomy for a mesophytic 2.5-cm tumor, developed gross hematuria. Prompt CT imaging, followed by therapeutic angio-embolization of a third-order segmental renal artery with coils, treated the pseudoaneurysm successfully. CONCLUSIONS: Renal-artery pseudoaneurysm is a rare, potentially life-threatening, condition that often is difficult to diagnose and requires a high index of clinical suspicion. Early use of selective angio-embolization minimizes morbidity and maximizes renal conservation. The etiology, diagnosis, and management are discussed.