case_images: PMC10506877_01
case_images: Axial nonenhancement (a) and venous phase CT (b) show increased right kidney size secondary to subcapsular and perirenal hematoma conditioning inferior vena cava displacement (*). Coronal venous phase CT (c) shows hematic fluid along the right lateral paracolic gutter to the ipsilateral iliac fossa (arrowhead).
case_images: CRIRA2023-5570992.001.jpg
case_images: PMC10506877_01_CRIRA2023-5570992.001.jpg
case_images: fig1
case_images: The study showed a subcapsular and perirenal hematoma in the right kidney (Figure 1).
case_images: Axial nonenhancement (a), portal venous (b), and delayed phases (c) CT images show a subcapsular and perirenal hematoma on the right kidney. The portal venous phase (b) shows contrast extravasation (arrows) and changes in size, attenuation, and shape in the delayed phase (c).
case_images: CRIRA2023-5570992.002.jpg
case_images: PMC10506877_01_CRIRA2023-5570992.002.jpg
case_images: fig2
case_images: Signs of active bleeding as contrast medium extravasation were noticed in the inferior renal pole (Figure 2).
case_images: Digital subtraction angiography of the right renal artery (a) and coronal venous phase CT image (b) demonstrate active extravasation from the subsegmental arteries.
case_images: CRIRA2023-5570992.003.jpg
case_images: PMC10506877_01_CRIRA2023-5570992.003.jpg
case_images: fig3
case_images: The patient was transferred to the angiography room where subtraction renal angiography demonstrated at least twelve sites of active arterial bleeding (Figure 3).
case_images: Digital subtraction angiography of the right renal artery (a) demonstrates embolization of the bleeding vessel with no residual bleeding. Coronal venous phase CT image (b) shows a decrease in the size of the subcapsular hematoma and absence of bleeding foci.
case_images: CRIRA2023-5570992.004.jpg
case_images: PMC10506877_01_CRIRA2023-5570992.004.jpg
case_images: fig4
case_images: Fifteen minutes later, a new angiography showed the absence of right renal artery flux and no signs of further bleeding (Figure 4).