Hemoragie renală acută într-un caz de rinichi unic congenital şi angiomiolipom

Abstract

Renal angiomyolipoma is the most common solid renal mass arising from the mesenchymal elements of the kidney. The complications include acute renal hemorrhage, one of the most common clinical urological emergencies. We pre­sent the case of a 64-year-old female patient with non­spe­ci­fic general symptoms, known with solitary left congenital kidney and renal angiomyolipoma. The contrast-enhanced computed tomography (CECT) allowed to detect the pre­sence of renal hematoma with active bleeding from an ar­te­rial feeding vessel, and the presence of intratumoral fat. Renal angiography via right femoral approach with di­gi­tal subtraction acquisitions (DSA) demonstrated active blee­ding within the lesion; the embolization of the feeding ar­te­rial vessel with multiple tornado-type metallic coils was performed with subsequent reduction of blood flow. CECT studies are essential for a proper management of com­pli­ca­ted renal angiomyolipomas. Endovascular therapy is a viable, minimally invasive alternative to classical ne­phrec­to­my for the control of renal bleeding.