[Bilateral spontaneous perirenal hematoma: an unusual complication of polyarteritis nodosa].
BACKGROUND
Spontaneous perirenal hematoma is a serious and unusual complication of polyarteritis nodosa. Its treatment is not standardized. A review of the literature shows that therapeutic arterial embolization is an alternative to nephrectomy.


METHODS
We report a new case of spontaneous bilateral perirenal hematoma due to a rupture of a renal aneurysm in a 68-year-old patient presenting with polyarteritis nodosa. The patient had no hypertension. Renal arteriography helped guide the diagnosis, and selective embolization was performed to treat the left hematoma. The right hematoma only required symptomatic treatment.


CONCLUSIONS
Arteriography with selective embolization appears to be a good alternative to nephrectomy in spontaneous perirenal hematoma complicating polyarteritis nodosa. However, in this case, the right hematoma required neither arteriography nor nephrectomy. This raises the questions of the necessity of selective embolization when the clinical status remains satisfying with a symptomatic treatment.
Launay
D
D
Service de médecine interne A, hôpital Claude-Huriez, CHRU, Lille, France.
Michon-Pasturel
U
U
Boumbar
Y
Y
Dubrulle
F
F
Bouroz-Joly
J
J
Hachulla
E
E
Lemaitre
L
L
Devulder
B
B
D000368:Aged; D000792:Angiography; D004621:Embolization, Therapeutic; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D008297:Male; D010488:Polyarteritis Nodosa / Q000150:complications*; D012077:Renal Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed