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Fig. 2 | Insights into Imaging

Fig. 2

From: Letter to the editor: spontaneous renal haemorrhage in end-stage renal disease

Fig. 2

A 56-year-old Chinese man with hypertension, diabetes and chronic kidney failure undergoing regular haemodialysis suffered from acute abdomen pain with hypotension. Unenhanced (a), corticomedullary (b) and nephrographic (c) multidetector CT acquisitions showed a large left-sided subcapsular renal haematoma (*) and typical features of ESRD, including small cortical cysts (thin arrows). Note the minimal associated perirenal and posterior pararenal bloody effusion (+ in c). Focal CM extravasation consistent with active bleeding was detected by CT (arrowhead in b) and confirmed at selective renal angiography (arrowhead in d), originating from a distal arterial branch at the lower half of the kidney. Angiography revealed severe luminal irregularities of all renal arteries and allowed occlusion of the left renal artery with an 8-mm Amplatzer vascular plug (AGA Medical Corp., Plymouth, MN: short arrows in e) distally to the inferior adrenal artery. Follow-up CT (f) confirmed the Amplatzer plug in site (short arrow) and stopped haemorrhage

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