414 Renal artery aneurysm after blunt trauma in a pediatric patient- A case report

Introduction

Renal artery aneurysm is a rare complication after renal trauma. Most patients are managed with minimally invasive techniques. However, in case of risk of expansion or rupture, surgical exploration may be warranted.

Here we present a case of a 10 year old girl who presented with renal artery aneurysm after blunt trauma.

Case report

A 10 year old girl presented in ER with sudden onset abdominal pain after history of fall. Fast scan showed free fluid in abdomen and right kidney injury. CT scan of abdomen showed grade V kidney injury and right renal artery aneurysm compressing inferior vena cava anteriorly and ascending colon laterally. CT angiogram was done which confirmed a ruptured renal artery aneurysm.

Patient was initially being managed conservatively and angiography was planned. She, however, became vitally unstable and her haemoglobin level dropped. Patient was taken to operation theatre urgently. Per- operatively, a ruptured right renal artery aneurysm was found, 2cm from aorta, causing a large hematoma compressing surrounding structures and dilated renal vein. Right nephrectomy was done. Patient remained stable and was discharged with an uneventful recovery.

Discussion

Renal artery aneurysm is an extremely rare complication following blunt trauma in paediatric population. Diagnosis is difficult, hence requires high level of clinical suspicion. Angiography is the standard tool for diagnosis and management. However, in case of hemodynamic instability, operative management may be warranted.

Conclusion

Despite its rarity, renal artery aneurysm may occur in children after blunt trauma. Hence, high suspicion should be kept by the clinicians in these cases.