[Arteriovenous fistula and kidney pelvis thrombus after percutaneous kidney puncture]

Percutaneous renal biopsy was performed in a 40-year old transplant recipient suffering from renal function impairment. The examination of the main transplant artery by duplex Doppler ultrasonography showed normal values for the resistive index and renal blood flow volume. Postbioptic realtime ultrasonography showed an echogenic mass in the renal collecting system, which was dilatated in prior examinations. In addition, we found an arteriovenous fistula by colour coded Doppler ultrasonography showing a characteristic Doppler wave-form shape in an interlobar artery. No changes in the resistive index and renal flow volume could be demonstrated by Doppler examination of the main renal artery. The complications of percutaneous biopsy disappeared spontaneously. Although the incidence of major complications after renal graft biopsy with the automated biopsy instrument is very low, our report demonstrates typical complications following percutaneous renal biopsy. We conclude that B-scan and colour coded Doppler ultrasonography are sensitive diagnostic methods to observe patients post biopsy for potential complications.