RÉSUMÉ
We present a 71-year-old woman with spontaneous perinephric hematoma due to a rupture of pseudoaneurysm of the right renal artery on the fourth day after radical cystectomy and bilateral ureterocutaneostomy for bladder cancer. This patient received steroid therapy for chronic rheumatoid arthritis for several years. The digital subtraction angiography of the right renal artery showed two pseudoaneurysms in the anterior inferior segmental branch and the posterior inferior segmental branch. Transarterial coil embolization of the right renal artery proximally and distally to the two aneurysms was performed without complications. Moreover, the additional angiography showed typical string-of-beads appearance and small aneurysms in abdominal visceral arteries, suggesting segmental arterial mediolysis (SAM) as a possible etiology. Differential diagnoses of SAM are discussed.
Sujet(s)
Faux anévrisme/étiologie , Rupture d'anévrysme/étiologie , Complications postopératoires , Artère rénale , Tunique moyenne/anatomopathologie , Maladies vasculaires/complications , Sujet âgé , Faux anévrisme/thérapie , Rupture d'anévrysme/thérapie , Cystectomie , Diagnostic différentiel , Imagerie diagnostique , Embolisation thérapeutique , Femelle , Hématome/étiologie , Humains , Maladies du rein/étiologie , Urétérostomie , Tumeurs de la vessie urinaire/chirurgie , Maladies vasculaires/diagnostic , Maladies vasculaires/anatomopathologieRÉSUMÉ
An anterior urethral valve is uncommon compared to a posterior urethral valve as a cause of lower obstructive uropathy. Furthermore, an anterior urethral valve in the fossa navicularis is extremely rare. We describe the case in a 6-year-old boy who presented with a split urinary stream. Endoscopy revealed an anterior urethral valve in the fossa navicularis, and we successfully incised the valve with a hook knife. We should consider the possibility of an anterior urethral valve in any child with an abnormal urinary stream.
