Abstract
Renal aneurysms are a rare entity with an incidence of 0.09% of the population. They are often asymptomatic and frequently discovered incidentally during abdominal imaging for unrelated causes. Rupture of renal artery aneurysms is a surgical emergency, very often lethal. Swift diagnosis is crucial and is made by ultrasound and abdominal MDCT. We report the case of a renal artery rupture in a 58 year-old man who arrived in the emergency department with left flank pain of sudden onset followed by a hypovolemic shock. MDCT scan showed the rupture of an aneurysm of the left renal artery associated with a retroperitoneal hematoma. It is a life-threatening situation in case of delayed diagnosis. In our case, prompt imaging and diagnosis led to conservative treatment and nephrectomy was avoided.
Highlights
Renal artery aneurysms are a rare entity and their complications such as spontaneous rupture are uncommon
Rupture of renal artery aneurysm is considered to be a surgical emergency that presents with sudden onset of flank pain, hematuria and hypovolemic shock due to retroperitoneal haemorrhage
Case Report A 58-year-old man with no prior medical history presented to the emergency department with severe left flank pain of sudden onset
Summary
Renal artery aneurysms are a rare entity and their complications such as spontaneous rupture are uncommon. Rupture of renal artery aneurysm is considered to be a surgical emergency that presents with sudden onset of flank pain, hematuria and hypovolemic shock due to retroperitoneal haemorrhage. CT images in the arterial phase demonstrated an aneurysm of the left renal artery (diameter: 2.8 cm) as well as an intermittent bleeding in the retroperitoneal space. The hematoma occupied the entire left anterior renal space measuring 20cm in length. The source of this retroperitoneal haemorrhage was the left renal artery aneurysm rupture and more precisely its anterior-superior part, leading to an active bleeding (Fig A, B, C and D). Figure C, D: Coronal MIP shows 2 x 2 cm aneurysm ( A, wide large arrow) of the distal portion of left renal artery
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