UNMASKING THE UNUSUAL: A CASE REPORT OF A 48-YEAR OLD FEMALE WITH RIGHT RENAL ARTERIOVENOUS MALFORMATION PRESENTING AS SECONDARY HYPERTENSION AND HEMATURIA

 

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https://storage.unitedwebnetwork.com/files/1099/57a08ed5caeb1e5c96d98f113f1ded8a.pdf
UNMASKING THE UNUSUAL: A CASE REPORT OF A 48-YEAR OLD FEMALE WITH RIGHT RENAL ARTERIOVENOUS MALFORMATION PRESENTING AS SECONDARY HYPERTENSION AND HEMATURIA

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Keth Noren
Reston
Keth Noren Reston restonketh@gmail.com Chong Hua Hospital Adult Nephrology Cebu Philippines *
Maia Celeste Arbatin mcarbatinmd@gmail.com Chong Hua Hospital Adult Nephrology Cebu Philippines -
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Renal arteriovenous malformations (AVMs) are exceptionally rare vascular anomalies, estimated to occur in less than 0.04% in the general population. Congenital AVMs of the cavernous type, specifically, are less common and often remain silent until they manifest with symptoms that mimic more common pathologies, leading to delays in diagnosis and management

This is a case of 48-year old, hypertensive female, who was initially admitted for terminal dysuria and gross hematuria with minimal blood clots. . CT stonogram initially revealed a soft tissue lesion in the right renal medulla. This prompted physician to order a CT urography which demonstrated a large aneurysm arising from the right renal artery. 

Renal angiogram demonstrating a hypertrophied right superior segmental artery supplying the bilobed aneurysm at the superior pole of the right kidney.A renal angiogram was done for definitive diagnosis and treatment. A hypertrophied right superior segmental artery supplying the bilobed aneurysm at the superior pole of the right kidney was visualized. Due to technical reasons, coiled embolization was not done and patient underwent a nephrectomy instead. Patient’s hypertension resolved post after the removal of renal arteriovenous malformation (AVM) and patient was off anti-hypertensive medications post-operatively.

Recognizing renal AVMs necessitates an elaborate diagnostic approach, as the indistinct symptoms of hypertension and hematuria can obscure the presence of this uncommon vascular pathology. Symptomatic AVMs often require treatment through endovascular or surgical techniques, which resolves symptoms and preserves kidney function.

Kewords