Delayed Bleeding After Retrograde Intrarenal Surgery: A Rare Complication in Ectopic Pelvic Kidney

Area of Science:

• Urology
• Interventional Radiology
• Nephrology

Background:

• Anatomical variations in pelvic ectopic kidneys (PEK) complicate stone management.
• Retrograde intrarenal surgery (RIRS) is a primary treatment for small to medium renal calculi.

Observation:

• A 57-year-old male with a 12 mm stone in a pelvic ectopic kidney underwent RIRS.
• Post-operatively, the patient experienced delayed recurrent hematuria and clot retention 37 days after the procedure.

Findings:

• Renal angiography identified an arteriocaliceal fistula as the source of bleeding.
• Superselective arterial embolization effectively controlled the hemorrhage.

Implications:

• Anomalous anatomy in PEKs increases the risk of surgical complications, including significant bleeding.
• Angioembolization is a viable treatment for massive bleeding from unusual arterial supply in PEK patients.