Presentation
Renal biopsy at outside hospital. Concern for ongoing renal haemorrhage. Hemodynamically unstable.
Patient Data
Large subcapsular haematoma surrounding right kidney. There is extensive haemorrhage in the perirenal as well as pararenal spaces. Haemorrhage extends into the right pelvis, as well as anteriorly into the intraperitoneal space of the right upper quadrant. Right kidney is displaced superiorly and medially.
On the first stack of images, superselective angiography demonstrates active extravasation of contrast. Contrast is seen extravasating out of the kidney.
The second image is from an angiography run that did not show continued extravasation of contrast following coil and liquid embolic embolisation.
Case Discussion
This is a case of an iatrogenic renal haemorrhage from a recent kidney biopsy. This resulted in a large subcapsular haematoma. On the triple phase CT (non-contrast, arterial phase, and portal venous phase), there was evidence of active haemorrhage. Interventional radiology emergently brought the patient to the suite to perform a renal angiography and embolisation. Angiography runs did not demonstrate continued haemorrhage. The patient's vitals stabilised after numerous transfusions.
Co-authors:
Faraz Khan, MD
Christine Cooley, MD
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