Active bleeding after kidney biopsy: Successful ultrasound-guided direct thrombin embolization into the cortical

Jose Miguel Escudero-Fernandez1, Mónica Bolufer Cardona2, Mercedes Perez Lafuente1

  • 1Servei de Radiologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain.

A 27-year-old man, previously diagnosed with IgA nephropathy, was referred for native kidney biopsy. After the procedure, the patient presented active bleeding revealed by Doppler and contrast-enhanced ultrasonography at the biopsy site. Successful embolization of the cortical fistula, the focus of bleeding, was achieved using ultrasound-guided thrombin injection and confirmed by Doppler ultrasonography, contrast-enhanced ultrasonography, and CT angiography. This case report shows that contrast-enhanced ultrasonography is useful for detecting active bleeding after a solid organ biopsy. Moreover, ultrasound-guided thrombin embolization is a safe and minimally invasive treatment and an alternative to angiography-guided embolization.

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