case_images: PMC11810628_01
case_images: Abdominal ultrasonography image depicting a relatively small right kidney measuring approximately 7.8 x 2.8 cm, with significantly reduced cortical thickness of up to 7 mm.
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case_images: The right kidney was relatively small, measuring 7.8 x 2.8 cm, with significantly reduced cortical thickness of up to 7 mm (Figure 1).
case_images: (A) A coronal MR T2 image depicting a 28-week intrauterine fetus (indicated by arrows). (B) A coronal MR T2 image illustrating a bulky heterogeneous lesion measuring approximately 14 x 13 x 15 mm, identified as an angiomyolipoma, which includes an organized hematoma and extensive hemorrhage (indicated by arrows). (C) An axial T2-weighted fat-saturated MR image revealing a bulky heterogeneous lesion measuring about 14 x 13 x 15 mm, suggesting a rupture of the angiomyolipoma and resulting in a large retroperitoneal perinephric hematoma with a focal central giant pseudoaneurysm measuring approximately 6 x 4.5 cm (indicated by arrows) and a small right kidney. (D) An axial T2-weighted fat-saturated MR image demonstrating the pseudoaneurysm with contrast extravasation and a small right kidney (indicated by arrows).
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case_images: ccr370183-fig-0002
case_images: This lesion contained giant pseudoaneurysms measuring 5 x 6 cm, observed within the renal system as a retroperitoneal hematoma, along with tortuous, abnormal-appearing renal arteries consistent with the rupture of an angiomyolipoma (Figure 2A-D).
case_images: (A) Before trans-arterial embolization of the aneurysms, the injection of contrast material reveals a glue cast (indicated by arrows). (B) Selective arteriography of the left renal artery following successful embolization demonstrates complete occlusion with metallic coils (indicated by arrows).
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case_images: ccr370183-fig-0003
case_images: AML and a significant intra-renal pseudoaneurysm measuring 5 x 6 cm (Figure 3A). A Progreat microcatheter was introduced to delineate the upper renal arteries and perform highly selective diagnostic angiography. Consequently, a micro coil (3 mm; Boston Scientific) was deployed (Figure 3B), but severe vasospasm of the renal artery occurred, causing a reduction in contrast flow to peripheral branches which could potentially precipitate renal ischemia.
case_images: Post-angiography color Doppler ultrasonography image taken 24 h after the procedure, demonstrating preserved color vascular Doppler signals in the posterior region of the left kidney. The vascularity remains unaffected by the administration of calling or PVA particle injection.
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case_images: ccr370183-fig-0004
case_images: For that, Nitroglycerin (50 mcg for three doses) was administered at five-minute intervals accompanied by meticulous blood pressure monitoring and the angiography showed a reduction of intra-renal arterial spasm and Doppler US studies also showed an enhancement in the kidney's vascularity (Figure 4).