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Sci Forschen Open HUB for Scientific Research Journal of Surgery: Open Access ISSN 2470-0991 | Open Access J Surg Open Access | JSOA 1 IMAGE ARTICLE Pseudoaneurysm Formaon aſter Laparoscopic Paral Nephrectomy Bruno Lopes Cancado Machado* Department of Urology, University of Arkansas for Medical Sciences, Lile Rock, Arkansas, USA Received: 12 Jun, 2018 | Accepted: 22 Jun, 2018 | Published: 27 Jun, 2018 Volume 4 - Issue 2 | DOI: hp://dx.doi.org/10.16966/2470-0991.169 *Corresponding author: Bruno Lopes Cancado Machado, Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA, E-mail: [email protected] Citaon: Machado BLC (2018) Pseudoaneurysm Formaon aſter Laparoscopic Paral Nephrectomy. J Surg Open Access 4(2): dx.doi.org/10.16966/2470-0991.169 Copyright: © 2018 Machado BLC. This is an open-access arcle distributed under the terms of the Creave Commons Aribuon License, which permits unrestricted use, distribuon, and reproducon in any medium, provided the original author and source are credited. e Laparoscopic Partial Nephrectomy (LPN) is the “gold standard” to management of small renal masses (Figure 1) [1,2]. e patient, a 38 year Male at 8 th post-operatory day from right upper pole PN, presented at ER with a voluminous gross hematuria (Figure 2). e clinical diagnosis was a renal pseudoaneurysm. e patient was hemodynamically stable, and a medical approach was tried. Aſter 12 hours of clinical management, the hematuria had not stopped. A transfemoral arteriography was done, and the Pseudoaneurysm diagnosis was confirmed (Figure 3). An intravascular embolization was performed (Figure 4) and the hematuria ceased in the day aſter. e patient had two small episodes of hematuria in the next 48 hours aſter the endovascular procedure. ose episodes were not Figure 1: Right Renal Tumor (Red Arrow) Figure 2: Gross Hematuria (post-operatory Day 7 after Laparoscopic Partial Nephrectomy) Figure 3: Upper Renal Pole Pseudo Aneurysm (before embolization) reflected in his hemodynamic status and laboratorial blood work. Aſter one and a half year of follow up, the patient has no oncologic or hematuria recurrence. e pseudoaneurysm aſter LPN is a rare event. It happens in only 2% or less of the patients [2]. e prompt diagnosis and treatment are crucial to avoid major complications [3].

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Sci ForschenO p e n H U B f o r S c i e n t i f i c R e s e a r c h

Journal of Surgery: Open AccessISSN 2470-0991 | Open Access

J Surg Open Access | JSOA 1

IMAGE ARTICLE

Pseudoaneurysm Formation after Laparoscopic Partial NephrectomyBruno Lopes Cancado Machado*

Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA

Received: 12 Jun, 2018 | Accepted: 22 Jun, 2018 | Published: 27 Jun, 2018

Volume 4 - Issue 2 | DOI: http://dx.doi.org/10.16966/2470-0991.169

*Corresponding author: Bruno Lopes Cancado Machado, Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA, E-mail: [email protected]

Citation: Machado BLC (2018) Pseudoaneurysm Formation after Laparoscopic Partial Nephrectomy. J Surg Open Access 4(2): dx.doi.org/10.16966/2470-0991.169

Copyright: © 2018 Machado BLC. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

The Laparoscopic Partial Nephrectomy (LPN) is the “gold standard” to management of small renal masses (Figure 1) [1,2]. The patient, a 38 year Male at 8th post-operatory day from right upper pole PN, presented at ER with a voluminous gross hematuria (Figure 2). The clinical diagnosis was a renal pseudoaneurysm. The patient was hemodynamically stable, and a medical approach was tried. After 12 hours of clinical management, the hematuria had not stopped. A transfemoral arteriography was done, and the Pseudoaneurysm diagnosis was confirmed (Figure 3). An intravascular embolization was performed (Figure 4) and the hematuria ceased in the day after.

The patient had two small episodes of hematuria in the next 48 hours after the endovascular procedure. Those episodes were not

Figure 1: Right Renal Tumor (Red Arrow)

Figure 2: Gross Hematuria (post-operatory Day 7 after Laparoscopic Partial Nephrectomy)

Figure 3: Upper Renal Pole Pseudo Aneurysm (before embolization)

reflected in his hemodynamic status and laboratorial blood work. After one and a half year of follow up, the patient has no oncologic or hematuria recurrence.

The pseudoaneurysm after LPN is a rare event. It happens in only 2% or less of the patients [2]. The prompt diagnosis and treatment are crucial to avoid major complications [3].

Sci Forschen

O p e n H U B f o r S c i e n t i f i c R e s e a r c h

Citation: Machado BLC (2018) Pseudoaneurysm Formation after Laparoscopic Partial Nephrectomy. J Surg Open Access 4(2): dx.doi.org/10.16966/2470-0991.169 2

Journal of Surgery: Open AccessOpen Access Journal

Figure 4: Upper Renal Pole Pseudo Aneurysm (after embolization)

References1. Sampogna G, Pugliese R, Elli M, Vanzulli A, Forgione A (2017)

Routine clinical application of virtual reality in abdominal surgery. Minim Invasive Ther Allied Technol 26: 135-143.

2. Gupta N, Patel A, Ensor J, Ahrar K, Ahrar J, et al. (2017) Multiple Renal Artery Pseudoaneurysms in Patients Undergoing Renal Artery Embolization Following Partial Nephrectomy: Correlation with RENAL Nephrometry Scores. Cardiovasc Intervent Radiol 40: 202-209.

3. Işik A, Firat D, Idiz UO (2018) Approaches to Recurrent/Complicated and Acute Cases. Turkiye Klinikleri Journal of General Surgery Special Topics 11: 112-114.