Pseudoaneurysm of the lower pole segmental artery of the kidney following open nephrolithotomy using an avascular approach: a case report

Abstract

Aneurysms are abnormalities in blood vessels that can be categorized as true aneurysms or pseudoaneurysms. Pseudoaneurysms occur when one or more layers of the blood vessel wall rupture, often as a result of trauma or medical procedures, such as nephrolithotomy. This case study discusses a pseudoaneurysm of the lower pole segmental artery of the kidney that developed after an open nephrolithotomy despite an avascular surgical plan. The patient experienced intermittent gross hematuria, highlighting the potential complications associated with renal surgeries. The diagnosis was challenging, necessitating a high suspicion index and imaging modalities such as ultrasound, CT scans, and angiography. Treatment options varied from conservative management to angioembolization, which is preferred for its minimally invasive nature and ability to preserve renal parenchyma. This study aims to demonstrate that the risk of pseudoaneurysm should be considered even in an atrophic nephrolithotomy performed without vascular invasion.