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Renal artery embolization of perirenal hematoma in hemorrhagic fever with renal syndrome: a case report.

Choi HS, Lee YS, Hwang JC, Lim JH, Kim KS, Yoon Y - Korean J Radiol (2007 Jul-Aug)

Bottom Line: Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure.Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings.We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dongguk University International Hospital, Dongguk University College of Medicine, 814 Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-dong 410-773, Korea.

ABSTRACT
Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.

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Related in: MedlinePlus

A 48-year-old man with hemorrhagic fever with renal syndrome complicated by perirenal hematoma.A. Physical examination on admission reveals petechial rashes on the whole body.B. The contrast enhanced CT scan obtained on admission reveals active extravasation of contrast media (arrow) in the inferior portion of the left kidney and perirenal hematoma.C. The coronal reformatted image also shows active extravasation of contrast media at the inferior portion of the left kidney (arrow) with massive perirenal hematoma extending into the pelvic cavity (short arrows).D,E. Selective left renal arteriography (D) and superselective renal arteriography (E) show active extravasation of contrast media from ruptured branches of the inferior division of the renal artery (arrows). There is no hypervascular mass or arteriovenous malformation.F. Selective left renal arteriography performed after superselective embolization with microcoils demonstrates no more extravasation of contrast media.
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Figure 1: A 48-year-old man with hemorrhagic fever with renal syndrome complicated by perirenal hematoma.A. Physical examination on admission reveals petechial rashes on the whole body.B. The contrast enhanced CT scan obtained on admission reveals active extravasation of contrast media (arrow) in the inferior portion of the left kidney and perirenal hematoma.C. The coronal reformatted image also shows active extravasation of contrast media at the inferior portion of the left kidney (arrow) with massive perirenal hematoma extending into the pelvic cavity (short arrows).D,E. Selective left renal arteriography (D) and superselective renal arteriography (E) show active extravasation of contrast media from ruptured branches of the inferior division of the renal artery (arrows). There is no hypervascular mass or arteriovenous malformation.F. Selective left renal arteriography performed after superselective embolization with microcoils demonstrates no more extravasation of contrast media.

Mentions: A 48-year-old man visited emergency department due to left lower abdominal pain and oliguria he had suffered with for three days and two days, respectively. He had experienced fever, chills and headache for one week prior to admission. The physical examination on admission revealed petechial rashes on the whole body (Fig. 1A) and tenderness in the left lower abdomen and left flank. He wasn't taking any antiplatelet drugs. The laboratory examination revealed leukocytosis, mild anemia, thrombocytopenia, increased serum creatinine and hyperkalemia. The prothrombin time and partial thromboplastin time were normal.


Renal artery embolization of perirenal hematoma in hemorrhagic fever with renal syndrome: a case report.

Choi HS, Lee YS, Hwang JC, Lim JH, Kim KS, Yoon Y - Korean J Radiol (2007 Jul-Aug)

A 48-year-old man with hemorrhagic fever with renal syndrome complicated by perirenal hematoma.A. Physical examination on admission reveals petechial rashes on the whole body.B. The contrast enhanced CT scan obtained on admission reveals active extravasation of contrast media (arrow) in the inferior portion of the left kidney and perirenal hematoma.C. The coronal reformatted image also shows active extravasation of contrast media at the inferior portion of the left kidney (arrow) with massive perirenal hematoma extending into the pelvic cavity (short arrows).D,E. Selective left renal arteriography (D) and superselective renal arteriography (E) show active extravasation of contrast media from ruptured branches of the inferior division of the renal artery (arrows). There is no hypervascular mass or arteriovenous malformation.F. Selective left renal arteriography performed after superselective embolization with microcoils demonstrates no more extravasation of contrast media.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627153&req=5

Figure 1: A 48-year-old man with hemorrhagic fever with renal syndrome complicated by perirenal hematoma.A. Physical examination on admission reveals petechial rashes on the whole body.B. The contrast enhanced CT scan obtained on admission reveals active extravasation of contrast media (arrow) in the inferior portion of the left kidney and perirenal hematoma.C. The coronal reformatted image also shows active extravasation of contrast media at the inferior portion of the left kidney (arrow) with massive perirenal hematoma extending into the pelvic cavity (short arrows).D,E. Selective left renal arteriography (D) and superselective renal arteriography (E) show active extravasation of contrast media from ruptured branches of the inferior division of the renal artery (arrows). There is no hypervascular mass or arteriovenous malformation.F. Selective left renal arteriography performed after superselective embolization with microcoils demonstrates no more extravasation of contrast media.
Mentions: A 48-year-old man visited emergency department due to left lower abdominal pain and oliguria he had suffered with for three days and two days, respectively. He had experienced fever, chills and headache for one week prior to admission. The physical examination on admission revealed petechial rashes on the whole body (Fig. 1A) and tenderness in the left lower abdomen and left flank. He wasn't taking any antiplatelet drugs. The laboratory examination revealed leukocytosis, mild anemia, thrombocytopenia, increased serum creatinine and hyperkalemia. The prothrombin time and partial thromboplastin time were normal.

Bottom Line: Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure.Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings.We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Dongguk University International Hospital, Dongguk University College of Medicine, 814 Siksa-dong, Ilsandong-gu, Goyang-si, Gyeonggi-dong 410-773, Korea.

ABSTRACT
Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.

Show MeSH
Related in: MedlinePlus