Large aneurysm in renal angiomyolipoma causing life-threatening retroperitoneal hemorrhage
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Date
2014Author
Magabe, P.C
Otele, W
Mugambi, L.M
Language
enMetadata
Show full item recordAbstract
Large aneurysms occurring in renal angiomyolipomas (AML) may be encountered. When present, they
have a higher propensity to hemorrhage and cause catastrophic intratumoral and perirenal hemorrhages.
They also tend to occur more in tuberous sclerosis-associated AML rather than in the sporadic form.
A 22-year-old female presented with sudden onset of acute right abdominal pain, hematuria and fainting. At
evaluation in the emergency department, the patient was found to be in hemorrhagic shock with hemoglobin
of 4 g/dl and low blood pressure of 60/40 mmHg. Fullness and tenderness of the right abdominal flank was
also noted. Contrast enhanced CT scan of the abdomen showed a large fatty mass of the right kidney
with a surrounding perirenal hematoma. A 4.0 cm wide focus of contrast was seen within the mass highly
suspicious of an aneurysm. A subsequent DSA angiogram of the right kidney confirmed the presence of the
aneurysm within the mass as the cause of the hemorrhage. The patient underwent successful emergency coil
and particle embolization of the aneurysm and mass with control of the bleeding. The patient was diagnosed
with tuberous sclerosis syndrome with further clinical findings of cutaneous adenoma sebaceum and lung
cystic changes.
Citation
African Journal of Urology (2014) 20, 193–196Publisher
Pan African Urological Surgeons’ Association
Collections
- Faculty of Health Sciences (FHS) [10387]