case_images: PMC3109788_01
case_images: Ultrasound image (a) and computed tomography image (b) showing the hematoma (arrows) within the abdominal wall overlying the graft kidney
case_images: IJN-21-62-g001.jpg
case_images: PMC3109788_01_IJN-21-62-g001.jpg
case_images: F0001
case_images: Ultrasonography showed a hematoma within the abdominal wall overlying the graft kidney with no perinephric fluid [Figure 1a]. The hematoma increased in size the next day and a non-enhanced CT scan was done [Figure 1b].
case_images: Digital subtraction angiography image showing a pseudoaneurysm (arrow) arising from the ascending branch of the deep circumflex iliac artery. Embolisation coils are seen within the lower pole of the graft kidney. The post-embolisation angiogram (b) showed stasis in the supplying vessel
case_images: IJN-21-62-g002.jpg
case_images: PMC3109788_01_IJN-21-62-g002.jpg
case_images: F0002
case_images: Additionally, a pseudoaneurysm arising from the ascending branch of the deep circumflex iliac artery was seen [Figure 2a], which was embolized using gelfoam slurry and polyvinyl alcohol (PVA) particles [Figure 2b].
case_images: Digital subtraction angiography image of the second session showing the pseudoaneurysm (arrow) being filled by small anastomosing vessels
case_images: IJN-21-62-g003.jpg
case_images: PMC3109788_01_IJN-21-62-g003.jpg
case_images: F0003
case_images: Since the hematocrit did not stabilize despite transfusion of blood, platelets and fresh frozen plasma, a repeat angiogram with left common femoral artery approach and selective cannulation of the internal mammary artery was done which revealed persistent opacification of the pseudoaneurysm by collateral vessels in the right iliac fossa [Figure 3].
case_images: (a) Digital subtraction angiography image showing multiple anastomosing branches (arrow) of the superior epigastric artery anastomosing in the right lower abdomen. Radioopaque cholecystectomy clips are also seen (b) Post embolisation angiogram showing stasis in the superior epigastric artery
case_images: IJN-21-62-g004.jpg
case_images: PMC3109788_01_IJN-21-62-g004.jpg
case_images: F0004
case_images: Using a 4F Glide Headhunter (Cook, Bloomington, USA) catheter and coaxial microcatheter technique, a selective angiogram of the right internal mammary artery was done to demonstrate the superior epigastric artery and its anastomosing vessels branching toward the right lower abdomen [Figure 4a] which were embolized using PVA particles and gelfoam slurry [Figure 4b].