title: Late Rupture of Lumbar Artery as an Unusual Complication after Renal Biopsy - Case Report.
abstract: The most serious complication of renal biopsy is vascular damage with subsequent haemorrhage. To our knowledge, we present a first ever case of lumbar artery (LA) rupture accompanied by massive retroperitoneal bleeding, which developed after a significant amount of time following the biopsy itself. In a 63-year-old Caucasian female patient, a percutaneous left kidney biopsy was performed under continuous ultrasound guidance. On the fourteenth day after the procedure, she was examined for a sudden onset of left lumbar region pain. Computed tomography angiography showed a large retroperitoneal hematoma with active bleeding from the fourth left LA. Successful endovascular superselective embolization was performed immediately. The predisposing factor for the late haemorrhage could have been anticoagulation therapy, renal insufficiency and older age. Our case report highlights the need for caution, especially when performing kidney biopsy in a group of high-risk patients, particularly if they are indicated for subsequent anticoagulant therapy.
authors.affiliation: Department of Internal Medicine III - Nephrology, Rheumatology and Endocrinology, University Hospital Olomouc, Olomouc, Czech Republic.
authors.forename: Karel
authors.initials: K
authors.lastname: Krejčí
authors.forename: Marie
authors.initials: M
authors.lastname: Černá
authors.forename: Kamil
authors.initials: K
authors.lastname: Žamboch
authors.forename: Jiří
authors.initials: J
authors.lastname: Orság
authors.forename: Anna
authors.initials: A
authors.lastname: Klíčová
authors.forename: Josef
authors.initials: J
authors.lastname: Zadražil
mesh_terms: D001158:Arteries / Q000293:injuries*; D001706:Biopsy / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008161:Lumbosacral Region / Q000098:blood supply; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012187:Retroperitoneal Space; D012421:Rupture / Q000209:etiology; D013997:Time Factors