Primary Renal Vein Aneurysm Rupture: Case Report of a Catastrophic Entity

Renal vein aneurysms (RVAs) are uncommon entities, which are usually incidental findings or may cause mild nonspecific symptoms. Modern radiological imaging, mainly multislice computed tomography (CT), has substantially contributed to a prompt and accurate diagnosis. Treatment may range from watchful waiting to aneurysmorraphy, aneurysmectomy, and nephrectomy. Potential complications include thrombosis, pulmonary embolism, pressure to other structures, and rupture.

A 58-year-old male patient was admitted at the emergency department with abdominal pain. He underwent an emergency CT scan which showed a huge retroperitoneal hematoma around the right kidney, while soon afterward he had a hypovolemic shock, less than an hour after a temporary loss of consciousness after an acute emotional distress episode. He underwent an emergency laparotomy and a right nephrectomy because of an RVA. Interestingly, his postoperative course was uneventful and his six-month follow-up was normal.

This report presents the rupture of an RVA for the first time, which was successfully treated through nephrectomy by general surgeons in a secondary hospital. This is a catastrophic event which may be lethal, in case prompt diagnosis and surgical intervention delay. Due to the rarity of the disease, its etiology and optimal treatment remain to be clarified.