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[Bleeding renal angiomyolipomas. CT findings]
Sergio Salerno1, Antonio Lo Casto, Fortunato Sorrentino
1Sezione di Scienze Radiologiche, DIBIMEL, Policlinico Universitario P. Giaccone, Università degli Studi, Palermo. radpa@unipa.it
Insights
Computed Tomography (CT) effectively identifies bleeding renal angiomyolipomas, a rare cause of abdominal hemorrhage. Prompt diagnosis is crucial for guiding surgical intervention in these critical cases.
Area of Science:
- Radiology
- Urology
- Pathology
Background:
- Renal angiomyolipomas are benign tumors.
- Hemorrhage from these tumors can lead to acute abdominal conditions.
Purpose of the Study:
- To report on three cases of abdominal hemorrhage due to bleeding renal angiomyolipomas.
- To evaluate the role of Computed Tomography (CT) in diagnosing these cases.
Main Methods:
- Retrospective review of three patients with symptomatic renal angiomyolipomas.
- Emergency abdominal CT scans were performed.
- Surgical intervention and histological confirmation were obtained for all patients.
Main Results:
- CT identified renal lesions with inhomogeneous density and characteristic fat-density areas in all patients.
- Lesion sizes ranged from 5-9 cm.
- Two lesions were in the right kidney, one in the left.
Conclusions:
- Renal angiomyolipomas can cause hypovolemic shock.
- CT is valuable for diagnosing the cause of hemorrhage.
- Diagnosis is straightforward with typical fat content but can be challenging with atypical presentations.
Purpose:
To describe our experience in three cases of abdominal haemorrhage caused by bleeding renal angiomyolipomas, which were studied with Computed Tomography (CT).
Materials And Methods:
A retrospective study carried out at our archives identified 3 patients (aged 58.6 on average) with renal angiomyolipomas clinically manifested with acute abdomen and haemorrhage. The patients underwent an emergency CT scan of the abdomen. One patient also under-went a subsequent renal angiography. All patients had surgery and histological characterizations of the renal lesions.
Results:
The CT study on all three patients allowed detection of a lesion in the kidneys with inhomogeneous density due to haemorrhage. Areas with fat-density values (-60 -80 UH) were always observable within the lesions. The lesions, measuring 5-9 cm, were located in the right kidney in two patients and in the left kidney in one.
Conclusions:
In 40% of patients, renal angiomyolipoma may account for a picture of hypovolemic shock, so a correct diagnostic approach is important to guide the surgical approach. CT allows detection of the angiomyolipoma as the cause of the haemorrhage in most cases. The diagnosis is relatively simple when the lesion has typical features such as adipose content, whereas it may be difficult with non-typical aspects. Furthermore the fat content may also be detected in varying quantities in other renal lesions responsible for bleeding.
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