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Asymptomatic Renal Pseudoaneurysm Following Laparoscopic Partial Nephrectomy.
Peter E Lonergan1, Cormac Farrelly2, Tony Geoghegan2
1Department of Urology, Mater Misericordiae University Hospital, Dublin, Ireland.
Urology
|May 20, 2016
Summary
A rare complication of kidney surgery, renal pseudoaneurysm, was found incidentally in an asymptomatic patient six months post-operation. This finding highlights that large pseudoaneurysms can be asymptomatic and are treatable with angioembolization.
Area of Science:
- Urology
- Vascular Surgery
- Radiology
Background:
- Minimally invasive partial nephrectomy is a standard procedure for localized renal tumors.
- Renal pseudoaneurysms are uncommon but serious complications after renal surgery.
- Typical presentation involves gross hematuria in the early postoperative period.
Observation:
- A 66-year-old woman presented with an incidentally discovered 4 cm left renal lesion on surveillance CT 6 months after laparoscopic partial nephrectomy.
- The lesion demonstrated avid arterial enhancement, indicative of a renal pseudoaneurysm.
- The patient remained completely asymptomatic.
Findings:
- This case illustrates a delayed and asymptomatic presentation of a renal pseudoaneurysm.
- The size of the pseudoaneurysm (4 cm) may contribute to its asymptomatic nature.
- Computed tomography (CT) accurately identified the pseudoaneurysm based on its enhancement pattern.
Implications:
- Renal pseudoaneurysms, even large ones, can be asymptomatic incidental findings.
- Angioembolization is an effective treatment option for renal pseudoaneurysms.
- Surveillance imaging protocols should be mindful of potential delayed complications after nephron-sparing surgery.
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