Life-threatening intra-abdominal hemorrhage from left superior colonic artery pseudoaneurysm after percutaneous renal biopsy: successful treatment with superselective arterial embolization

Abstract 

Life-threatening intra-abdominal hemorrhage following ultrasonographically guided percutaneous renal biopsy is extremely rare and, most of the time, is due to renal vascular injury. Injury of other abdominal arteries during percutaneous renal biopsy is exceedingly rare. We report herein a case of left superior colonic artery injury during ultrasonographically guided percutaneous renal biopsy, which was responsible for pseudoaneurysm formation and subsequent intra-abdominal hemorrhage and gastrointestinal bleeding. Arterial pseudoaneurysm was rapidly and successfully treated with minimally invasive endovascular treatment using microcoils. Superselective embolization stopped the bleeding and preserved colonic vascularization, thus preventing ischemia of the involved colonic segment.

Keywords: Percutaneous renal biopsy, Embolization, Arterial embolization, Inferior mesenteric artery, Endovascular treatment, Gastrointestinal bleeding, Hemorrhage, Pseudoaneurysm