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Radiological treatment of a spontaneously ruptured inferior adrenal artery aneurysm
James Manners1, Rajinder Singh, Andrew Page
1Department of Urology, Royal Hampshire County Hospital, Romsey Road, Winchester, Hampshire, UK.
Background:
A 70-year-old man with a history of hypertension presented with severe epigastric discomfort that radiated to his back. CT revealed cystic kidney disease and a large retroperitoneal hemorrhage, and CT angiography identified an active bleeding point in the region of the left adrenal gland. Selective left renal angiography identified a small inferior adrenal artery aneurysm with active hemorrhage. The patient underwent successful transcatheter embolization with microcoils and polyvinyl alcohol microparticles to control the bleeding.
Investigations:
Blood tests, urinalysis, electrocardiography, triphasic CT with CT angiography.
Diagnosis:
Ruptured left inferior adrenal artery aneurysm.
Management:
Access to the inferior adrenal artery was achieved with a microcatheter, followed by transcatheter embolization using a combination of polyvinyl alcohol microparticles distally and microcoils proximally to the aneurysm.
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