Rupture and hemorrhage of pseudoaneurysm in the left pararenal artery: a case report and literature review
10.12483/j.issn.1009-8291.2026.02.009
- VernacularTitle:左侧副肾动脉假性动脉瘤破裂出血1例报告并文献复习
- Author:
Chaoyue WU
1
;
Liangliang HAO
2
;
Jianming XI
3
;
Jinrong MA
2
;
Jiawei ZHAO
2
;
Yongsheng JIN
4
Author Information
1. School of Medicine, Yan'an University, Yan'an 716000; Department of Urology, Affiliated Hospital of Yan'an University, Yan'an 716000
2. School of Medicine, Yan'an University, Yan'an 716000
3. Department of Intervention, Affiliated Hospital of Yan'an University, Yan'an 716000, China
4. Department of Urology, Affiliated Hospital of Yan'an University, Yan'an 716000
- Publication Type:Journal Article
- Keywords:
pararenal artery;
pseudoaneurysm;
embolization therapy;
retroperitioneal hemorrhage
- From:
Journal of Modern Urology
2026;31(2):153-156
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the diagnostic ideas, clinical characteristics and treatment methods of the rupture of pseudoaneurysm in the pararenal artery, so as to provide reference for the management of such condition.Methods The diagnosis and treatment process of a patient with massive retroperitoneal hemorrhage due to rupture of pseudoaneurysm in the left pararenal artery admitted to the Affiliated Hospital of Yan'an University were reported, and relevant literature was retrieved to summarize the etiology, pathogenesis, diagnosis and treatment of this disease.Results The patient was a 49-year-old male who presented with sudden onset of lumbar and abdominal pain.After admission, enhanced computed tomography (CT) scan indicated a cystic lesion in the left kidney, along with fluffy high-density and fluidic density shadows around the kidney.There was extensive extravasation of contrast agent in the lower polar artery of the left kidney, with rupture shadows, retention of contrast agent, and the extent of extravasation expanding in the venous phase and delayed phase, suggesting that the renal artery or pararenal artery had ruptured and bled.After consultation by the Department of Intervention, an urgent superselective left renal artery embolization procedure was performed.During the operation, angiography showed the “jetting sign” in the arterial phase, and the stenosis at the neck of the tumor.In the delayed phase, the contrast agent was retained accompanied with the “chimney sign”, which was consistent with the characteristics of a pseudoaneurysm.The final diagnosis was rupture and bleeding of a pseudoaneurysm of the left pararenal artery, along with the formation of a hematoma, as well as accumulation of blood and fluid in the abdominal and pelvic cavities.The patient recovered well after surgery.After a follow-up of 6 months, CT scan showed that the hematoma was basically absorbed and there were no obvious abdominal pain or other discomforts.Conclusion Rupture of pseudoaneurysm in the pararenal artery is rare in clinical practice.Treatment should be tailored to the anatomical features and the patients' condition.Multidisciplinary collaboration, precise imaging evaluation, and the application of interventional techniques can achieve efficient diagnosis and treatment, and protect the renal function to the greatest extent.
