A CASE OF BILATERAL RENAL ARTERY ANEURYSM COMPLAINING OF MICROSCOPIC HEMATURIA
Analysis of 171 Cases of Renal Artery Aneurysm in the Japanese Literature
1985 Volume 76 Issue 5 Pages 744-751
Details
1985 Volume 76 Issue 5 Pages 744-751
A 39-year-old female visited our clinic on August 13, 1983, complaining of asymptomatic microscopic hematuria found by a mass medical examination. On physical examination slight bruit was audible leftside on her back with otherwise normal findings. Her blood pressure was 140/80mmHg with a regular rhythm. With regard to the laboratory data, complete blood count and blood chemistry were within the normal limit. The urinary sediment showed microscopic hematuria (12-13/HPF). On the scout film there was a digital-fingertip-sized calcification near the right renal hilum. Intravenous pyelography demonstrated bilateral notches on the renal pelves (Fig. 1). Computed tomography showed a small mass and calcification at around the right renal hilum (Fig. 2). Aortography was done on a tentative diagnosis of the bilateral renal artery aneurysm and it showed clear bilateral aneurysms, right one measuring 2.2×2.1cm and left one 1.6×1.0cm (Fig. 3A and 3B). Both aneurysms were saccular in type and located at the first bifurcation of the renal artery.
On February 14, 1984, the right renal artery aneurysm was resected and the renal arterial branches were anastomosed side-to-end in situ (Fig. 4A, 4B, 5A and 5B). The left renal artery aneurysm was not operated on and was left to be followed up because the left one was seemed to be less dangerous than the right in view of the size and the configuration. In the near future the left renal artery aneurysm is to be operated on. The resected aneurysm (Fig. 6) was 2.4×2.0×1.7cm and had a small channel, 1.5mm in diameter, to the lumen of the right renal artery. The wall of the aneurysm was 2-3mm thick, yellowish white and elastic hard and had calcification in several places (Fig. 7). The convalescence was uneventful.
In addition, 171 cases of renal artery aneurysm in Japan were briefly reviewed. There were only 14 cases of bilateral renal artery aneurysms in the Japanese literature including this case, 83.3% of which were female.
In conclusion, it should be noted that microscopic hematuria could be a clue to the renal artery aneurysm.
