Electronic ISSN 2287-0237

VOLUME

A RUPTURED DISSECTING ANEURYSM OF THE RENAL ARTERY INTO THE PERINEPHRIC REGION: A CASE REPORT

FEBRUARY 2015 - VOL.9 | CASE REPORT

A case report of a ruptured dissecting aneurysm of the renal artery into the perinephric region. The patient presented at hospital with symptoms of severe acute colicky right flank pain with rapid deterioration. CT image demonstrates definite diagnosis and she recovers well after nephrectomy. The histology of the renal artery shows a dissecting renal arterial aneurysm due to cystic medial degeneration of the arterial wall.

Keywords:

ruptured dissecting aneurysm of renal artery, cystic medial degeneration of arterial wall,cystic medial necrosis

MEDIA
Figure 1A:
CT image on arterial phase axial section reveals elongation of right renal artery encircled by a round homo- genous density which is representative of an aneurysm (see arrows) with compression of the renal pelvis and displacing laterally.
Figure 1B:
CT image on delay phase axial section reveals contrast filled renal aneurysm perforating into perinephric region (see arrow).
Figure 1C:
CT image on coronal section on delay phase reveals the site of the renal aneurysm perforation into the perinephric space (see arrows).
Figure 2A:
3D reconstruction of aorta and renal arteries reveal elongation and stretching of right renal artery. The aneurysm and site of perforation are demonstrated.
Figure 2B:
3D reconstruction demonstrates extensive hemorrhage from renal aneurysm into retroperitoneal perinephric, right lumbar gutter and pelvic regions (see red color).
Figure 3A:
Gross photograph of opened aneurysm of renal artery and dilated renal pelvis.
Figure 3B:
Diagram corresponds to gross anatomy.
Figure 4:
Cystic medial degeneration of wall of aneurysm, (hematoxylin and eosin x200) see arrows.
Figure 5:
Cystic space containing extracellular matrix, (alcian blue x200) see arrows.
Figure 6:
Fragmentation of elastic lamina, (elastic stain x200) see arrow.
Figure 7:
Fragmentation of smooth muscle component, (Masson trichrome x200) see arrows.
Figure 8:
Blood-filled space in aneurysmal wall, (Masson trichrome x200) see arrows.
Figure 9:
Segmental chronic pyelonephritis, (hematoxylin and eosin x100) see arrows.
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