Page kidney secondary to large splenic artery aneurysm bleeding and its management by angioembolization

The Page kidney is a rare phenomenon that refers to hypertension resulting from any external compression of a kidney by a hematoma, tumor, lymphocele, or urinoma. The activation of the renin-angiotensin-aldosterone system is believed to be the main mechanism responsible for development of resistant hypertension in Page kidney.

We reported a patient with chronic pancreatitis who presented with hypotension due to splenic artery aneurysmal bleed; following the resuscitation, accelerated hypertension secondary to Page kidney caused by perinephric hematoma presented. Early diagnosis by contrast-enhanced computed tomography of the abdomen and renal angiogram was followed by therapeutic angioembolization. However, ultrasound guided aspiration was not done because of denial by the patient for further treatment. Follow-up showed normalization of blood pressure and resolution of hematoma on subsequent abdomen ultrasound evaluation.

Splenic artery aneurysm is a very uncommon cause of Page kidney and to our knowledge, it was the first case of its kind ever reported in the literature.