Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation

Most renal injuries in pediatric patients are treated conservatively, but prolonged hematuria and major blood vessel injuries often require active bleeding control. Traumatic pseudoaneurysms of segmental branches of the renal artery occur in 2.5% of renal injuries. They usually manifest as prolonged...

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Autores principales:	Anko Antabak, Dino Papeš, Krešimir Bulić, Ivo Sjekavica, Ivana Jurca, Dražen Perkov, Tomislav Luetić
Formato:	article
Lenguaje:	EN HR
Publicado:	Hrvatski liječnički zbor 2021
Materias:	hematuria – etiology; wounds nonpenetrating – complications; kidney – injuries; aneurysm false – etiology therapy; renal artetry – injuries; embolization Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b26719e82c9541eebc30ccb86b47f274
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spelling	oai:doaj.org-article:b26719e82c9541eebc30ccb86b47f2742021-12-03T08:11:06ZTraumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation10.26800/LV-143-3-4-60024-34771849-2177https://doaj.org/article/b26719e82c9541eebc30ccb86b47f2742021-04-01T00:00:00Zhttps://lijecnicki-vjesnik.hlz.hr/lijecnicki-vjesnik/traumatska-protrahirana-hematurija-i-pseudoaneurizma-segmentalne-arterije-bubrega-u-16-godisnjeg-djecaka-lijecena-endovaskularnom-embolizacijom/https://doaj.org/toc/0024-3477https://doaj.org/toc/1849-2177Most renal injuries in pediatric patients are treated conservatively, but prolonged hematuria and major blood vessel injuries often require active bleeding control. Traumatic pseudoaneurysms of segmental branches of the renal artery occur in 2.5% of renal injuries. They usually manifest as prolonged or intermittent secondary hematuria, but may be asymptomatic as well. Watchful waiting is the initial treatment, and around one third of patients eventually require active surgical or endovascular treatment. The two main endovascular coil embolisation methods are the “sandwich” and the “coil packing” technique, but occlusion using a stent is also possible. Traumatic prolonged hematuria caused by pseudoaneurysm of the renal segmental arterial branch, and the methods of treatment are rarely reported, especially in children. This report presents a boy in whom a blunt kidney injury lead to the formation of a pseudoaneurysm of the renal segmental arterial branch, causing prolonged hematuria. The patient was treated by endovascular embolisation through the right femoral artery, in local anesthesia and conscious sedation. A 2.7 Fr microcatheter was used to selectively enter the dominant cranial renal artery and show the pseudoaneurysm of a segmental interlobar arterial branch. A 2×4 mm coil was used to occlude the segmental interlobar arterial branch and pseudoaneurysm, with no post-procedural bleeding or significant renal segmental ischemia. Endovascular treatment offers advantages over open surgery, but has certain drawbacks as well, such as high radiation and contrast exposure. In the last few years, a minimally invasive robotic surgical procedure has been described for the treatment of intra-renal pseudoanurysm. The current worldwide trend in pediatric renal injuries treatment is the reduction in the number of nephrectomies, and a shift to non-operative and minimally invasive treatment, including endovascular procedures. University Hospital Centre Zagreb has all the specialities and capacities required for surgical and endovascular procedures in children, making it the national referral centre for pediatric renal injuries treatment.Anko AntabakDino PapešKrešimir BulićIvo SjekavicaIvana JurcaDražen PerkovTomislav LuetićHrvatski liječnički zborarticlehematuria – etiology; woundsnonpenetrating – complications; kidney – injuries; aneurysmfalse – etiologytherapy; renal artetry – injuries; embolizationMedicine (General)R5-920ENHRLiječnički vjesnik, Vol 143, Iss 3-4, Pp 108-112 (2021)
institution	DOAJ
collection	DOAJ
language	EN HR
topic	hematuria – etiology; wounds nonpenetrating – complications; kidney – injuries; aneurysm false – etiology therapy; renal artetry – injuries; embolization Medicine (General) R5-920
spellingShingle	hematuria – etiology; wounds nonpenetrating – complications; kidney – injuries; aneurysm false – etiology therapy; renal artetry – injuries; embolization Medicine (General) R5-920 Anko Antabak Dino Papeš Krešimir Bulić Ivo Sjekavica Ivana Jurca Dražen Perkov Tomislav Luetić Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
description	Most renal injuries in pediatric patients are treated conservatively, but prolonged hematuria and major blood vessel injuries often require active bleeding control. Traumatic pseudoaneurysms of segmental branches of the renal artery occur in 2.5% of renal injuries. They usually manifest as prolonged or intermittent secondary hematuria, but may be asymptomatic as well. Watchful waiting is the initial treatment, and around one third of patients eventually require active surgical or endovascular treatment. The two main endovascular coil embolisation methods are the “sandwich” and the “coil packing” technique, but occlusion using a stent is also possible. Traumatic prolonged hematuria caused by pseudoaneurysm of the renal segmental arterial branch, and the methods of treatment are rarely reported, especially in children. This report presents a boy in whom a blunt kidney injury lead to the formation of a pseudoaneurysm of the renal segmental arterial branch, causing prolonged hematuria. The patient was treated by endovascular embolisation through the right femoral artery, in local anesthesia and conscious sedation. A 2.7 Fr microcatheter was used to selectively enter the dominant cranial renal artery and show the pseudoaneurysm of a segmental interlobar arterial branch. A 2×4 mm coil was used to occlude the segmental interlobar arterial branch and pseudoaneurysm, with no post-procedural bleeding or significant renal segmental ischemia. Endovascular treatment offers advantages over open surgery, but has certain drawbacks as well, such as high radiation and contrast exposure. In the last few years, a minimally invasive robotic surgical procedure has been described for the treatment of intra-renal pseudoanurysm. The current worldwide trend in pediatric renal injuries treatment is the reduction in the number of nephrectomies, and a shift to non-operative and minimally invasive treatment, including endovascular procedures. University Hospital Centre Zagreb has all the specialities and capacities required for surgical and endovascular procedures in children, making it the national referral centre for pediatric renal injuries treatment.
format	article
author	Anko Antabak Dino Papeš Krešimir Bulić Ivo Sjekavica Ivana Jurca Dražen Perkov Tomislav Luetić
author_facet	Anko Antabak Dino Papeš Krešimir Bulić Ivo Sjekavica Ivana Jurca Dražen Perkov Tomislav Luetić
author_sort	Anko Antabak
title	Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
title_short	Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
title_full	Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
title_fullStr	Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
title_full_unstemmed	Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
title_sort	traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation
publisher	Hrvatski liječnički zbor
publishDate	2021
url	https://doaj.org/article/b26719e82c9541eebc30ccb86b47f274
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Traumatic prolonged hematuria and pseudoaneurysm of the renal segmental arterial branch in a 16-year-old boy treated by endovascular embolisation

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