Thapa N, Maharjan S, Hona A, Pandey J, Karki S. Spontaneous rupture of renal angiomyolipoma and its management: A case report.
Ann Med Surg (Lond) 2022;
79:104037. [PMID:
35860139 PMCID:
PMC9289389 DOI:
10.1016/j.amsu.2022.104037]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022] Open
Abstract
a) Introduction and Importance
Angiomyolipomas of kidney are benign lesions that are generally an incidental finding on imaging. Rupture of angiomyolipoma is rare and fatal complication that requires early intervention.
b) Case Presentation
A 38 year old male patient presented with symptoms of right flank pain for 2 days. On clinical examination patient looked anxious, pale with right flank tenderness, guarding and signs of shock.
c) Clinical findings and investigations
CT scan showed renal angiomyolipoma with aneurysm formation and bleed from the lesion. Blood profile revealed low hemoglobin.
d) Interventions and Outcome
Right nephrectomy performed along 6 cycles of cardiopulmonary reususcitaion done with stable post operatively vitals.
e) Conclusion
Early diagnosis of complication of angiomyolipoma requires thorough clinical examination and judicious use of imaging. Immediate embolization or surgery must be performed for better outcome and survival rate.
Angiomyolipoma is composed of fat, smooth muscle and blood vessels and presents among 0.3% of the population.
Renal angiomyolipoma are prone to aneurysm formation and bleed, however a nontraumatic spontaneous renal hemorrhage from a sporadic renal angiomyolipoma is a rare condition.
Mostly angiomyolipoma are asymptomatic and are diagnosed incidentally. CT scan is the diagnostic modality of choice.
Patients with life-threatening hemorrhage require immediate intervention that includes embolization or surgery for better outcome and survival rate.
Collapse