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British Journal of Radiology (2007) 80, e262-e264
© 2007 British Institute of Radiology
doi: 10.1259/bjr/36343011
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Rupture of renal artery aneurysm into the renal pelvis, clinically mimicking renal colic: diagnosis with multidetector CT

V De Wilde, MD 1 K Devue, MD 2 F Vandenbroucke, MD 1 C Breucq, MD 1 M De Maeseneer, MD 3 and J De Mey, MD 1

Departments of 1 Medical Imaging and 2 Emergency, Vrije Universiteit Brussel, Belgium and 3 Department of Radiology, University of Michigan Health System, Ann Arbor, USA


Figure 1
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  		Figure 1. Abdominal radiography. This image was initially interpreted as non-specific by the emergency room physician. Retrospectively, marginal calcifications can be seen to the left of the L2 vertebra (arrows), corresponding to aneurysmal rim calcification. The pattern of distended small bowel loops (B) can be explained as a sign of retroperitoneal irritation.

 

Figure 2
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  		Figure 2. Transverse CT image. High-density contrast medium is seen in the aorta in prevertebral location and in the renal artery aneurysm (P). Marginal calcifications (long arrows) are also noted in the wall of the aneurysm. Important perirenal collections (double arrows) are seen.

 

Figure 3
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  		Figure 3. Transverse CT image shows perirenal and pararenal collection(short arrows) with streaky aspect corresponding to haemorrhage. Also note contrast in the ureter (long white arrow) and wedge-shaped renal infarction (I) in the kidney. Renal cyst (C ) is also seen.

 

Figure 4
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  		Figure 4. Coronal reconstructed CT image. Renal artery(black arrow) is seen to originate from atheromatous aorta. Aneurysm with marginal calcification is located adjacent to renal pelvis and immediately fills with contrast medium (A). The pelvis (long white arrow) and ureter (small white arrows) also immediately fill with contrast medium. A lateral displacement of the collecting system secondary to the pressure of the aneurysm can be seen.

 




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