Arterial embolization of retained kidney remnant following blunt traumatic injury: A case report.
BACKGROUND
There has been a recent trend toward nonoperative management of solid organ injuries with arteriography and embolization as alternatives to surgical exploration. We examine the use of arterial embolization in the management of a post-subtotal nephrectomy urinoma in a patient with severe renal injury secondary to blunt trauma.


METHODS
This case report has been reported in line with the CARE criteria [13].


METHODS
A 35-year-old female patient presented with a persistent urinoma after an incomplete nephrectomy for blunt renal trauma. Computed tomography scan of the abdomen demonstrated a 47×68×101 mm3collection superior to the remnant of the resected right kidney. With persistence of the urinoma after placement of an 8 French drainage catheter, the patient was taken for arterial embolization of the lower renal artery for ablation of the kidney remnant.


CONCLUSIONS
Most kidney injuries with urinoma formation are treated successfully with supportive measures, however refractory cases require intervention. Arterial embolization has been used successfully in the treatment of traumatic pseudoaneurysms, arteriovenous fistulas, and some renal tumors. In this patient, we extended the use of embolization to infarct vessels of the functioning kidney remnant as an alternative to surgery. Post-embolization the patient recovered well with permanent resolution of the urinoma and short-term side effects limited to short-lived fever and lumbar pain.


CONCLUSIONS
Arterial embolization should be considered as an alternative to surgery in cases of persistent urinoma following renal trauma with retained remnants.
St George's University, St. George's, Grenada, West Indies; King's County Hospital Center, SUNY Downstate University, 451 Clarkson Avenue, Brooklyn, NY 11203, USA. Electronic address: npozzi@sgu.edu.
Natalie
N
Pozzi
St George's University, St. George's, Grenada, West Indies; King's County Hospital Center, SUNY Downstate University, 451 Clarkson Avenue, Brooklyn, NY 11203, USA. Electronic address: skoblick@sgu.edu.
Sarah
S
Koblick
King's County Hospital Center, SUNY Downstate University, 451 Clarkson Avenue, Brooklyn, NY 11203, USA. Electronic address: patopato@gmail.com.
Patricia
P
Leung
King's County Hospital Center, SUNY Downstate University, 451 Clarkson Avenue, Brooklyn, NY 11203, USA. Electronic address: Leon.boudourakis@nychhc.org.
Leon
L
Boudourakis
Arterial embolization; Minimally invasive management; Nephrectomy; Renal trauma; Solid organ injury; Urinoma