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Doctor's Information

Name : Morteza &Hamidreza
Family : Sanei Taheri &Haghighatkhah
Affiliation :shahid beheshti university of medical science,shohada hospital,radiology department
Academic Degree : the second year radiology resident
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : mersad mehrnahad

Case Section

Interventional Radiology

Patient's Information

Gender : Male
Age : 30

Clinical Summary

intermittent hematiuria after PCNL

Imaging Findings

ct scan findings:
hypodense tract of PCNL is seen which is associated with hyperdense lesion in pyelocalyceal system
delayed exceratory phase of right kidney because of hematoma in right pelvis is seen
selective right renal angiography findings:
aneurysmal dilation of segmental branch of right renal artery
treated by interarterial coiling

Differential Diagnosis

Renal-artery-aneurysm

Final Diagnosis

renal-artery-aneurysm

Discussion (Related Text)

Renal artery aneurysms (RAA) are considered the second most common visceral aneurysm (15-22%), most common being splenic artery aneurysm (60%). They are more common in females. Most of the lesions are saccular and tend to occur at the bifurcation of main renal artery Most cases are asymptomatic. Symptoms usually arise from rupture of aneurysm, embolisation of peripheral vascular bed or arterial thrombosis 1. Hypertension is associated in up to 73% cases of these aneurysm. Haematuria has also been reported in many cases
Aetiology 1-2
•fibromuscular dysplasia (34%)
•degenerative aneurysm (25%)
•vasculitides (e.g. Behcet disease)
•phakomatoses (e.g. tuberous sclerosis, neurofibromatosis)
•intrinsic collagen deficiency (Marfan syndrome, Ehlers-Danlos syndrome)
•trauma
Radiographic features
CT
•noncontrast: soft tissue mass lesion in the region or course of renal artery
•postcontrast: contrast-filled outpouching in the course of the renal artery
Angiography
Aneurysms can be well detected and characterized by angiography, in terms of size, neck diameter and type.

References

http://radiopaedia.org/articles/renal-artery-aneurysm

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