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Polymer-glue as a life and kidney function saver: a life-threatening hemorrhage in the ruptured upper pole artery of the kidney managed by percutaneous embolization - a case report and literature review

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Antoniewicz A. , Wojtkowska I. , Dziekiewicz M. , Kępka C. , Kremis E. , Zapała Ł. , Skiba R. , Stępińska J.

Open Medicine

2013

tom 8

nr 3

339-342

In this paper we report the case of a nearly fatal hemorrhage in the artery of the renal upper pole that occurred in a 84-year-old woman on anticoagulation treatment in connection with aortic valve replacement 4 days prior to the incident. The artery was injured during the evacuation of a hematoma of the right pleural cavity. While the patient was in the intensive care unit recovering from cardiac valve surgery, the consulting urologist was summoned in order to cope with massive hematuria and acute urine retention. Unfortunately, conservative urological management based on catherization via a three-way catheter and constant transurethral lavage with saline was unsuccessful. Angio-computed tomography revealed a ruptured branch of the renal upper pole artery. A highly selective embolization using histoacryl injection during percutaneous angioplasty was performed. There were no complications in the following days. The patient was subject to postoperative follow-up at 3, 6 and 9 months and renal scintigraphy was performed at 6 months revealing symmetrical function of both kidneys without any changes in the upper pole of the right kidney.