Congenital renal arteriovenous malformation: a rare cause of visible haematuria

Multimodal imaging techniques for the diagnosis of congenital left renal arteriovenous fistula: A case report

BACKGROUND

Congenital renal arteriovenous fistula (RAVF) is a clinically rare condition and frequently missed and misdiagnosed. Multimodal imaging techniques can provide more detailed diagnostic information to help physicians more accurately diagnose and treat diseases. Combining imaging methods to diagnose RAVF has rarely been reported.

CASE SUMMARY

A 69-year-old female patient presented with gross hematuria that had persisted for 10 days. The patient underwent ultrasound examinations of the kidneys and renal blood vessels, enhanced computed tomography, three-dimensional computed tomography angiography, and digital subtraction angiography of the renal arteries. These revealed dilatation of the left renal vein and abnormal shunting between the left renal artery and vein. The patient was diagnosed with a left RAVF using combined multimodal imaging techniques. The patient was treated with left renal artery embolization immediately after renal arteriography. Hematuria resolved following the left renal artery embolization without serious bleeding or other complications. The patient made a full recovery after one year of postoperative follow-up.

CONCLUSION

Multimodal imaging techniques complement each other when diagnosing RAVF, providing detailed diagnostic information that can aid in accurate diagnosis and treatment. In addition, this case reminds the sonographer to pay more attention to the color doppler flow imaging and blood flow spectrum when examining the kidney, so as to avoid misdiagnosis of renal cystic lesions as renal cysts and missed diagnosis of RAVF.

Multimodal Ultrasound Diagnosis of Congenital Renal Arteriovenous Malformation: A Case Report

Traditionally, computed tomography angiography has been considered the gold standard for diagnosing renal arteriovenous malformation (AVM). Despite the sensitivity of ultrasound in detecting AVM through Doppler techniques, it often lacks the ability to provide detailed insights into the lesion. In this narrative, we present a case of unexplained hematuria accompanied by flank pain, which was conclusively diagnosed as congenital renal AVM via multimodal ultrasound. The pivotal contributions of color Doppler ultrasound and contrast-enhanced ultrasound are that they are instrumental in enabling an early and markedly precise diagnostic pathway.

Renal arteriovenous malformation causing hematuria: Case report and review of the literature

RATIONALE

Renal arteriovenous malformations are rare vascular morphological anomalies that can be classified as congenital, idiopathic and acquired, of which congenital renal arteriovenous malformations are the most common. This disease is a rare cause of hematuria. In this case report, we report the diagnosis and treatment of a patient with renal arteriovenous malformation. We also review the symptoms, diagnosis and treatment of renal arteriovenous malformations in the published literature.

PATIENT CONCERNS

A 35-year-old female patient presented to a local hospital with right-sided lumbar abdominal pain with hematuria for 2 days. Physical examination showed percussion pain in the right renal area. Laboratory tests such as routine blood and blood biochemistry did not show any significant abnormalities when the patient entered the hospital. Considering the patient's medical history, a urological computed tomography scan showed blood accumulation in the right renal pelvis, upper middle ureter and bladder. Subsequently, routine blood tests showed that the patient's red blood cells and hemoglobin continued to decrease. An emergency renal arteriogram was performed, which showed a tortuous right upper renal pole branch artery and multiple thickened veins communicating with it.

DIAGNOSIS

This patient was diagnosed with cirsoid renal arteriovenous malformation.

INTERVENTIONS

Renal artery embolization was performed immediately after the renal arteriogram was performed on the patient.

OUTCOMES

On review of the angiogram, the tortuous right upper renal pole branch artery was found to be obstructed, and the thickened vein disappeared, and the renal vein was normally visualized in due course. On the third postoperative day, the patient was free of hematuria. Physical examination showed no percussion pain in the renal area. The patient healed and was discharged. A 1-year follow-up was performed and the patient gave feedback that she no longer had symptoms such as back pain and hematuria in her daily life.

LESSONS

This case illustrates that early use of vascular interventions is an important method for the diagnosis and treatment of cirsoid renal arteriovenous malformations.