Renal artery pseudoaneurysm is a rare vascular lesion usually caused by trauma or percutaneous urological procedures. Spontaneous rupture of pseudoaneurysms without predisposing events, especially in hemodialysis patients, has rarely been reported.
A 25-year-old man receiving maintenance hemodialysis visited the emergency room because of sudden severe right flank pain. He had no history of trauma or urological procedures except for a left renal biopsy to diagnose Alport syndrome 10 years prior.
Contrast-enhanced computed tomography revealed a right perirenal hematoma with pseudoaneurysms.
On renal angiography, multiple pseudoaneurysms were observed in the right renal artery branches and embolization was performed.