Embolization with absolute ethanol injection of insufficiently ligated renal artery after open nephrectomy.
A 54-year-old woman was admitted to hospital for hypotension and anemia which was due to intermittent hemorrhage from a lumbar drain. She had undergone open nephrectomy ten days earlier in another hospital for the right dysfunctional kidney with staghorn calculi. Ultrasound in our hospital showed a right retroperitoneal hematoma. Surgical exploration was performed twice whereby the hematoma was partially eliminated; however, the point of bleeding was not identified. Repeated attacks of bleeding from the drain accompanied by acute pain made the hypotension with tachycardia even worse, which led to a life-threatening hemorrhagic shock. Extravasation from the insufficiently ligated right renal artery was then shown on computed tomography aortography. After selective catheterization of this arterial stump with a mixture of alcohol and contrast media, complete occlusion of the remaining part of the resected renal artery was achieved. Application of absolute alcohol, though risky, proved to be a quick and efficient alternative method of occlusion of the bleeding renal arterial stump.
Markovic
Biljana
B
Department of Radiology, University of Belgrade Medical Faculty, Belgrade, Serbia. bimar@verat.net
Markovic
Zeljko
Z
Pejcic
Tomislav
T
D004621:Embolization, Therapeutic / Q000379:methods*; D000431:Ethanol / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008026:Ligation / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D012077:Renal Artery; D018570:Risk Assessment; D016896:Treatment Outcome
D000431:Ethanol