2018 Volume 38 Issue 5 Pages 879-882
We encountered a case of traumatic renal arteriovenous fistula and report the treatment results here, as patients with this condition are rare in Japan. The patient was a 90-year-old woman who fell into a sub-floor storage compartment and received medical attention for a left rib fracture at a local clinic. Shortly thereafter, she developed hematuria, and at the subsequent visit to the clinic, she presented with tachycardia and hypotension and was immediately transferred to our hospital by ambulance. A contrast-enhanced abdominal CT revealed injury to the left kidney, determined as type Ⅲb according to the 2008 classification system for renal injury by the Japanese Association for the Surgery of Trauma. At that time, early detection of the renal vein in the images? was also observed. We suspected that the patient had developed a traumatic renal arteriovenous fistula, which we then confirmed by renal arteriography. Transcatheter arterial embolization (TAE) was performed to occlude the fistula, after which the hematuria gradually resolved. The patient was transferred to the urology department 10 days after the initial trauma. TAE is an established treatment method for renal trauma, and this case corroborates the evidence that TAE can be performed safely even in cases with complicating renal arteriovenous fistula.
