Article Text

Download PDFPDF
Bilateral acute pyelonephritis with left renal artery aneurysm as a cause of bilateral spontaneous subcapsular haematoma: lessons learnt
  1. Bhaumik Barad,
  2. Sriram Krishnamoorthy and
  3. Natarajan Kumaresan
  1. Department of Urology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamilnadu, India
  1. Correspondence to Dr Sriram Krishnamoorthy; sriramuro{at}


Forniceal ruptures after acute pyelonephritis are relatively common. Bilateral spontaneous subcapsular haematoma (SSCH) is an uncommon sequela to pyelonephritis. We report a case of SSCH where the underlying cause of haematoma was a vascular anomaly. A 38-year-old woman with diabetes presented with fever, flank pain and shock following cystoscopy and Double J stenting done elsewhere. CT abdomen showed left subcapsular renal haematoma, managed by pigtail insertion. Postoperative CT showed right renal subcapsular haematoma and left moderate renal subcapsular haematoma. Renal angiogram showed pseudo-aneurysm on the left middle polar artery for which selective embolisation was performed. Physicians and urologists who come across SSCH for which no definite aetiology could be identified should keep in mind the possibility of an underlying vascular anomaly that could precipitate such a condition. The purpose of this report is to highlight the importance of remembering vascular causes in such unexplained cases of SSCH.

  • haematuria
  • catheterisation / catheter care
  • urinary tract infections

Statistics from


  • Contributors BB was involved primarily in patient care and prepared the manuscript with images. SK was the operating surgeon who motivated BB to prepare the manuscript. NK is Professor and Head of the Department of Urology and provided guidance throughout the course.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.