Journal of Korean Society of Ultrasound in Medicine 2009;28(4): 241-245.
A Renal Perforating Artery Mistaken for Arterial Bleeding after Percutaneous Renal Biopsy: A Case Report.
Yelim Kim, Chang Hee Lee, Kyeong Ah Kim, Cheol Min Park
Department of Radiology, College of Medicine, Korea University, Korea. chlee86@hanmail.net
  Published online: December 1, 2009.
ABSTRACT
Perirenal hematoma after a renal biopsy is a common complication that usually resolves spontaneously, but this rarely requires transfusions or surgical/radiological intervention. We report here on a case of a renal perforating artery that was mistaken for renal arterial bleeding in a 53-year-old woman who was complicated with perirenal hematoma after undergoing a percutaneous renal biopsy. On the color and pulsed wave Doppler ultrasonography, linear blood flow was seen in the perirenal hematoma, which extended perpendicularly from the renal parenchyma into the perirenal space, and this linear blood flow exhibited an arterial pulse wave. On CT angiography, the renal perforating artery was demonstrated as a curvilinear vessel coursing tangentially to the renal margin and we decided that it was a pseudolesion caused by the renal perforating artery. A renal perforating artery may be mistaken for renal arterial bleeding after a percutaneous renal biopsy. A renal perforating artery and arterial bleeding can be differentiated by the location and shape seen on a color Doppler examination and the pulse waves characteristics.
Keywords: Renal biopsy; Perirenal hematoma; Bleeding complication; Color Doppler ultrasonography; Renal perforating artery
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