Renal pseudoaneurysm after rigid ureteroscopic lithotripsy: A case report
Yi Hong Li1, Yi Sheng Lin2, Chao Yu Hsu1
1Division of Urology, Department of Surgery, Tungs' Taichung MetroHarbor Hospital, Taichung 43503, Taiwan.
World Journal of Clinical Cases
|October 3, 2022
Summary
This case report details the first instance of renal pseudoaneurysm following rigid ureteroscopic lithotripsy (URSL) for ureteral stones. Prompt intervention via arterial embolization successfully managed the bleeding complication.
Area of Science:
- Urology
- Endourology
- Interventional Radiology
Background:
- Ureteroscopic lithotripsy (URSL) is a standard treatment for ureteral stones.
- Rigid URSL is prevalent in Taiwan, despite flexible ureteroscopy's broader application.
- Persistent hematuria is a rare but serious complication of URSL.
Observation:
- A 57-year-old male developed a renal pseudoaneurysm with active bleeding post-rigid URSL.
- Symptoms included gross hematuria, severe left flank pain, and anemia (hemoglobin 6.8 g/dL).
- CT scan confirmed pseudoaneurysms in the upper and lower renal cortex.
Findings:
- This is the first reported case of renal pseudoaneurysm after rigid URSL.
- Transcatheter arterial embolization with microcoils effectively treated the pseudoaneurysm and bleeding.
- The patient's symptoms of flank pain and hematuria resolved post-embolization.
Implications:
- Renal pseudoaneurysms are a rare but significant risk following rigid URSL.
- Careful monitoring for refractory flank pain and gross hematuria is crucial post-procedure.
- Early diagnosis and intervention, such as embolization, are key to managing this complication.
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