Presentation
Renal biopsy at outside hospital. Concern for ongoing renal hemorrhage. Hemodynamically unstable.
Patient Data
Large subcapsular hematoma surrounding right kidney. There is extensive hemorrhage in the perirenal as well as pararenal spaces. Hemorrhage extends into the right pelvis, as well as anteriorly into the intraperitoneal space of the right upper quadrant. Right kidney is displaced superiorly and medially.
On the first stack of images, superselective angiography demonstrates active extravasation of contrast. Contrast is seen extravasating out of the kidney.
The second image is from an angiography run that did not show continued extravasation of contrast following coil and liquid embolic embolization.
Case Discussion
This is a case of an iatrogenic renal hemorrhage from a recent kidney biopsy. This resulted in a large subcapsular hematoma. On the triple phase CT (non-contrast, arterial phase, and portal venous phase), there was evidence of active hemorrhage. Interventional radiology emergently brought the patient to the suite to perform a renal angiography and embolization. Angiography runs did not demonstrate continued hemorrhage. The patient's vitals stabilized after numerous transfusions.
Co-authors:
Faraz Khan, MD
Christine Cooley, MD
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