Follow-up of a self-resolving renal pseudoaneurysm using contrast-enhanced power Doppler ultrasonography.
It has been standard practice to embolise a pseudoaneurysm caused by penetrating trauma whenever it is found, even in the absence of overt symptoms. This is a case report of a renal pseudoaneurysm (RPA) caused by a stab wound, which was safely monitored and followed using colour Doppler ultrasonography. On day 1, angiography showed a pseudoaneurysm of the renal artery in the parenchyma and ultrasonography showed blood flow into the pseudoaneurysm. Although abnormal blood flow into the kidney was seen, there appeared to be no leakage of blood from the pseudoaneurysm. The abnormal flow disappeared on day 12 and the area of the pseudoaneurysm became unclear from day 13. This report suggests the possibility that RPA caused by a stab wound could be an indication for conservative therapy under the following conditions: the RPA is detected initially; close monitoring using a colour Doppler ultrasound is possible; there is no leakage of blood from the right subclavian artery and there is a 2-week period of observation.
Sasaki
H
H
Emergency and Critical Care Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku, Tokyo, Japan. hsasaki@tokyo-med.ac.jp
Yukioka
T
T
Ohta
S
S
Noda
M
M
Homma
H
H
Mishima
S
S
D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000209:etiology; D003287:Contrast Media; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012075:Remission, Spontaneous; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000293:injuries*; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging*
D003287:Contrast Media