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Radiological treatment of a spontaneously ruptured inferior adrenal artery aneurysm

Nature Reviews Urology volume 7, pages 694–698 (2010)Cite this article

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Abstract

Background A 70-year-old man with a history of hypertension presented with severe epigastric discomfort that radiated to his back. CT revealed cystic kidney disease and a large retroperitoneal hemorrhage, and CT angiography identified an active bleeding point in the region of the left adrenal gland. Selective left renal angiography identified a small inferior adrenal artery aneurysm with active hemorrhage. The patient underwent successful transcatheter embolization with microcoils and polyvinyl alcohol microparticles to control the bleeding.

Investigations Blood tests, urinalysis, electrocardiography, triphasic CT with CT angiography.

Diagnosis Ruptured left inferior adrenal artery aneurysm.

Management Access to the inferior adrenal artery was achieved with a microcatheter, followed by transcatheter embolization using a combination of polyvinyl alcohol microparticles distally and microcoils proximally to the aneurysm.

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Figure 1: Coronal reconstruction of arterial-phase CT.
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Figure 7: Follow-up CT performed 12 months after embolization.

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Acknowledgements

Written consent for publication was obtained from the patient.

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Authors and Affiliations

  1. Department of Urology, Royal Hampshire County Hospital, Romsey Road, Winchester, SO22 5DG, Hampshire, UK

    James Manners, Rajinder Singh, Andrew Adamson & Duncan McLean

  2. Department of Radiology, Royal Hampshire County Hospital, Romsey Road, Winchester, SO22 5DG, Hampshire, UK

    Andrew Page

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  1. James Manners
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  2. Rajinder Singh
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Contributions

J. Manners and R. Singh researched data for the article. All authors made substantial contributions to discussion of content. A. Page, J. Manners and R. Singh wrote the article. A. Page, J. Manners, A. Adamson and D. McLean performed review/editing of the manuscript before submission.

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Correspondence to Andrew Page.

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The authors declare no competing financial interests.

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Manners, J., Singh, R., Page, A. et al. Radiological treatment of a spontaneously ruptured inferior adrenal artery aneurysm. Nat Rev Urol 7, 694–698 (2010). https://doi.org/10.1038/nrurol.2010.184

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