ABSTRACT
La cirugía renal conservadora ha llegado a ser el estándar en el tratamiento de lesiones tumorales renales de menos de 4 cm. El pseudoaneurisma de la arteria renal es una complicación rara de la nefrectomía parcial, sin embargo puede ser un cuadro grave y de difícil diagnóstico si no se tiene un alto índice de sospecha. El manejo dependerá de las condiciones del paciente, pudiendo llegar incluso a la nefrectomía de necesidad. A continuación presentamos un caso clínico de pseudoaneurisma post nefrectomía parcial manejado en forma exitosa con embolización selectiva.
Renal artery pseudo aneurism is an uncommon, severe and difficult to diagnose complication of partial nephrectomy. We report a 72 years old male subjected to a partial left nephrectomy to excise a 6 cm. diameter tumor. The patient was discharged four days after surgery, but was admitted again due to persistent hematuria. An ultrasound showed a cystic lesion in the kidney and clots in the ureter. A selective renal angiography showed a 4 cm diameter pseudo aneurism of the renal artery and a high flow arteriovenous fistula. Afferent branches were embolized and the fistula was completely occluded. A double catheter was installed in the ureter to resolve a hydronephrosis and the patient was discharged without symptoms, four days after admission.