Gross Hematuria after kidney biopsy. A case report

Abstract

We describe the clinical case of a patient experiencing severe gross hematuria causing clotting in the renal pelvis, after undergoing a kidney biopsy.The ecocolordopper and CT angiography performed did not reveal the cause of hematuria.The kidney arteriography allowed the diagnosis, revealing an arteriovenous fistula responsible for bleeding together with a small false aneurysm in the lower pole of the biopsied kidney. Both lesions were successfully treated with superselective embolization with microcoils.
We discuss about the diagnostic and therapeutic approach of these rare post-biopsy complications briefly focusing on the technical aspects and on possible risks that the transcatheter embolotherapy may result.

Key Words: embolization, microcoils, arteriovenous fistula, pseudoaneurysm, renal biopsy

Sorry, this entry is only available in Italian.

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Brachial artery pseudoaneurysm: a rare but serious complication in hemodialysis patients with arteriovenous fistula

Abstract

A pseudoaneurysm or false aneurysm of the brachial artery is an uncommon occurrence in patients receiving hemodialysis with arteriovenous fistula (AVF).
We describe the case of a 76-year-old woman presenting with a large, tender, pulsatile mass in the right antecubital region 10 cm from the AVF. B-mode ultrasound examination revealed a saccular hematoma. Color doppler showed a recirculation movement of blood, creating a two colors image called “Korean flag”. The patient was transferred to the surgical unit where she first underwent ultrasound-guided compression and then surgical repair of the pseudoaneurysm. Two weeks after surgery the AVF was used again as an access for hemodialysis.
Differentiating between a false and a true aneurysm based on ultrasound is not always straightforward. Doppler ultrasound findings can be decisive for the early diagnosis of a pseudoaneurysm to ensure proper treatment planning given the dangerous complications of ruptures. Treatment options include: compression, percutaneous thrombin injection, endovascular exclusion with covered stents, aneurysmectomy and surgical repair.

KEYWORDS: Pseudoaneurysm, Brachial artery, Doppler ultrasound, Arteriovenous fistula.

Sorry, this entry is only available in Italian.

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