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Updated: Sep 22, 2025

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Bilateral external iliac artery pseudoaneurysms causing urinary obstruction and acute renal failure
Marcelo Puppo Bigarella1, Roberto Iglesias Lopes2, Guilherme Gentile2
1Division of Urology, Department of Surgery, University of São Paulo School of Medicine, Rua Helena 218 4 floor 410 - Sartor Medicina, São Paulo, 04552-050, Brazil. marcelo.bigarella@gmail.com.
Background:
We report an exceedingly rare case of bilateral external iliac artery pseudoaneurysms causing urinary obstruction and acute renal failure.
Case Presentation:
A young man presented with acute severe bilateral testicular pain radiating to the back. Clinical and radiological workup showed bilateral external iliac artery pseudoaneurysms, which caused bilateral ureterohydronephrosis due to urinary obstruction with subsequent renal failure. Management included immediate bilateral external iliac artery endovascular repair and bilateral ureterolysis using a retroperitoneal approach, with resolution of the obstruction and successful endovascular treatment of both pseudoaneurysms. The only identifiable risk factor for cardiovascular disease was cocaine addiction.
Conclusions:
This case highlights an unusual and severe clinical presentation of bilateral EIA pseudoaneurysms causing bilateral ureterohydronephrosis and subsequent renal failure. Awareness of this condition may help avoid misdiagnosis and delayed management, which is of utmost importance for a favorable outcome.
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