Renal pseudo-aneurysm secondary to trivial abdominal trauma

Significant hematuria due to a pseudoaneurysm, needing endovascular intervention, after a trivial blunt abdominal trauma to an anatomically normal kidney is rare. A 49-year-old male patient presented with recurrent hematuria after a trivial blunt abdominal injury. Initial contrast computed tomography (CT) urogram done at the primary hospital missed any vascular injury. In view of episodes of recurrent severe hematuria, a CT angiogram was conducted that documented two pseudoanurysms. Angio-embolization and coiling of involved vessels was performed. This case is presented due to an unusual presentation by delayed recurrent hematuria from a pseudoaneurysm resulting from a trivial blunt abdominal injury to a non-diseased kidney. This case also stresses that a CT angiogram is needed to confirm vascular injury as a CT urogram can potentially miss reno-vascular injury.