Development of subcapsular hematoma in the pelvic kidney during peripheral angioplasty

Pelvic kidney is a mostly asymptomatic pathology resulting from failure of the kidneys to superior migration in fetal development. Herein, we report a 47-year-old female patient who presented with intermittent claudication in her right leg at 100 m. Significant stenosis was detected in the right superficial femoral artery and popliteal artery by computed tomography angiography. Peripheral angioplasty was performed for the treatment of consecutive lesions in the right lower extremity. Severe back pain developed during the procedure. Postprocedure computed tomography angiography showed a 35 mm wide subcapsular hematoma surrounding the pelvic kidney. The patient was followed up with conservative treatment on the first day. However, the next day, the patient's hemoglobin values decreased, and the pain persisted, thus angiography was performed. In the pelvic arteriography, an arteriovenous fistula was observed in the artery supply to the upper pole of the pelvic kidney. The fistula was closed with endovascular coil embolization. The patient who had no decrease in hemoglobin and no symptoms was discharged three days later. It is necessary to pay attention to the pelvic kidney during peripheral angiography, and it should be kept in mind that rare complications such as renal subcapsular hematoma may develop.