Spontaneous rupture of an aneurysmal arteriovenous fistula of the kidney causing massive retroperitoneal hemorrhage: a case report

Angiography depicted the arteriovenous fistula at the peripheral cortex of the kidney, which was treated superselective transcatheter arterial embolization (TAE). Bleeding was controlled and did not recur. The contrast-enhanced computed tomographic (CT) scan performed on the 27th day after the procedure revealed a parenchymal perfusion deficit of 3% and the return of serum creatinine concentration to pre-injury levels. We considered the selective coil embolization as the best treatment for the aneurysmal arteriovenous fistula located in the renal cortex to keep ischemic damage at a minimum and preserve renal function. To our knowledge, this is the 4th report of a spontaneous rupture in the retroperitoneum of an aneurysmal arteriovenous fistula.