Renal Subcapsular Hematoma after Percutaneous Transfemoral Angiography
A 54-year-old female was admitted to our hospital for the evaluation of unruptured cerebral aneurysm. She had a 5-year history of diabetes mellitus and hypertension. Eighteen months earlier, she had chest pain and underwent transfemoral cardiac angiogram at a different institute. Since then, she had been taking aspirin 100 mg under the diagnosis of angina. Percutaneous cerebral angiogram was performed through the right femoral artery. She was diagnosed as having multiple aneurysms in both the anterior communicating artery and in the paraclinoid portion of the internal carotid artery. The whole procedure of percutaneous cerebral angiogram was uneventful. However, about 3 hours later, she complained of left flank pain. Her blood pressure was 90/60 mm Hg and the body temperature was 36.4℃. On physical examination, the abdomen was soft but tender on the left upper quadrant. There was no evidence of puncture site bleeding or petechiae. Laboratory findings were white blood cell 6100/mm3, Hb 10.8 g/dL, platelets 174000/mm3. We performed abdominal computed tomography (CT). Abdominal CT showed a left renal subcapsular hematoma in the lower pole portion (). She was consulted by Urology Department and was advised to undergo supportive treatment. She had a followed-up abdominal CT seven days later. The follow-up abdominal CT showed a slight regression of the hematoma. She was discharged with improved conditions after 14 days of hospital stay. Six months later, her 64-cut multislice CT scan showed complete regression of the subcapsular hematoma (). Interestingly, in her three-dimensional angiogram, small accessory renal arteries supplying the lower pole of the kidney were found at both sides (). She has remained symptom free since then.