Renal artery pseudoaneurysm following a laparoscopic partial nephrectomy: hemorrhage after a successful embolization.

CASE REPORT A 26-year-old woman presented primarily with a transient left flank pain with no accompanying hematuria and urinary symptoms. Ultrasonography showed a 36-mm hypoechoic mass with dimensions in the middle part of her left kidney. Computerized tomography (CT) confirmed an enhanced hypodense mass of 30 × 25 mm in the middle lateral part of the left kidney (Figure 1). She underwent laparoscopic left partial nephrectomy with transperitoneal approach. The main renal artery was clamped with bulldog (ischemic time, 38 minutes), and then the tumor was resected. The kidney defect was approximated with 0-0 vicryl running sutures buttressed with hemostatic clip instead of knots. After declamping the renal artery, no significant bleeding was detected from the resection bed. On the 2nd postoperative day and due to a gross hematuria and massive clot passage, her hemoglobin dropped from 13.2 mg/dL to 8.5 mg/dL. After transfusion of packed red blood cell and the other conservative therapies, hematuria stopped and hemodynamic state improved. Thus, the patient was discharged 7 days after the operation.