Open Access Case report

Gross hematuria caused by a congenital intrarenal arteriovenous malformation: a case report

Gianpaolo Carrafiello1*, Domenico Laganà1, Gaia Peroni1, Monica Mangini1, Federico Fontana1, Davide Mariani1, Gabriele Piffaretti2 and Carlo Fugazzola1

Author Affiliations

1 Department of Radiology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy

2 Department of Vascular Surgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy

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Journal of Medical Case Reports 2011, 5:510  doi:10.1186/1752-1947-5-510

Published: 8 October 2011

Abstract

Introduction

We report the case of a woman who presented with gross hematuria and was treated with a percutaneous embolization.

Case presentation

A 48-year-old Caucasian woman presented with gross hematuria, left flank pain, and clot retention. The patient had no history of renal trauma, hypertension, urolithiasis, or recent medical intervention with percutaneous instrumentation. The patient did not report any bleeding disorder and was not taking any medication. Her systolic and diastolic blood pressure values were normal at presentation. The patient had anemia (8 mg/dL) and tachycardia (110 bpm). She underwent color and spectral Doppler sonography, multi-slice computed tomography, and angiography of the kidneys, which showed a renal arteriovenous malformation pole on top of the left kidney.

Conclusions

The feeding artery of the arteriovenous malformation was selectively embolized with a microcatheter introduced using a right transfemoral approach. By using this technique, we stopped the bleeding, preserved renal parenchymal function, and relieved the patient's symptoms. The hemodynamic effects associated with the abnormality were also corrected.