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BMJ Case Reports 2016; doi:10.1136/bcr-2015-212769
  • CASE REPORT

Acute renal failure and arterial hypertension due to subcapsular haematoma: is percutaneous drainage a feasible treatment?

  1. Ole Graumann3
  1. 1Institute of Clinical Medicine, Aarhus University, Aarhus N, Denmark
  2. 2Department of Urology, Aarhus University Hospital, Aarhus N, Denmark
  3. 3Department of Radiology, Aarhus University Hospital, Aarhus N, Denmark
  1. Correspondence to Marie Cæcilie Kobel, mariekobel{at}gmail.com
  • Accepted 3 January 2016
  • Published 18 January 2016

Summary

Percutaneous drainage proved to be successful in managing a renal subcapsular haematoma that was causing acute renal failure and hypertension in a 74-year-old woman. The patient presented with oliguria, nausea and malaise 2 days after a ureteronephroscopic procedure with biopsies of a suspected urothelial neoplasm in the right renal pelvis. The left kidney had recently been removed due to renal cell carcinoma. At admission, the patient's blood pressure and plasma creatinine levels were massively elevated. Ultrasonography revealed a moderate right-sided renal subcapsular haematoma. When the patient did not respond to antihypertensive treatment, Page kidney was suspected. A pigtail catheter was placed in the haematoma and, shortly after drainage, the diuresis resumed and plasma creatinine together with blood pressure decreased. This condition had previously been managed by open surgery, but recent case reports have described successful management by laparoscopy-assisted and radiology-assisted drainage, as described in this case report.

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