Selective embolization of pseudo-aneurysms of the renal artery after blunt abdominal injury in a patient with a single kidney

There is still controversy concerning imaging strategies and therapy for blunt renal injuryIe5. The object of radiographic imaging is to detect an injury to confirm the presence of a normal contralateral kidney, and to assess the extent of renal injury. In blunt abdominal injury and especially in patients with unstable circulation, abdominal ultrasound (AUS) is a reliable indicator of intra-abdominal bleeding”. In patients with unstable circulation, AUS and ‘one-shot’ intravenous urography (IVU) give additional information. These investigations allow the surgical team to verify bilateral renal function or urinary leakage, which indicates the need for exploration of the retroperitoneum during emergency laparotomy. In stable patients, contrastenhanced CAT scans (CECT) is superior to IVU and is indicated in the presence of haematuria, posterior penetrating injuries and deceleration injurieslP3. Early surgical intervention in major renal injury frequently lends to nephrectomy. When the kidney is the source of continuing haemorrhage following major injury, angiography is indicated followed by selective embolization., This can provide quick control of bleeding whilst maximizing renal prenchymal salvage, and should be attempted when the patient’s clinical condition permits and when the bleeding kidney has sufficient viable parenchyma to warrant attempted salvage”‘. We report such a case in a patient with only one kidney.