Endovascular management of an unsual case of spontaneous Retroperitoneal Haemorrhage due to Fibromuscular Dysplasia

Background Fibromuscular dysplasia (FMD) is an uncommon vascular disease that results in stenosis, dissection or aneurysmal degeneration. However, it can sometimes manifest atypically, as we show in this case. Case presentation A 24-year old patient with no relevant medical history with severe left...

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Published inCVIR endovascular Vol. 3; no. 1; pp. 64 - 5
Main Authors Molina-Nuevo, Juan David, López-Martínez, Lorena, Pedrosa-Jiménez, María José, Juliá-Molla, Enrique
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 09.09.2020
SpringerOpen
Subjects
Angioplasty
Case Report
Embolization
Fibromuscular dysplasia
Imaging
Interventional Radiology
Medicine
Medicine & Public Health
Radiology
Retroperitoneal haematoma
Embolization
Retroperitoneal haematoma
Angioplasty
Fibromuscular dysplasia
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Summary:Background Fibromuscular dysplasia (FMD) is an uncommon vascular disease that results in stenosis, dissection or aneurysmal degeneration. However, it can sometimes manifest atypically, as we show in this case. Case presentation A 24-year old patient with no relevant medical history with severe left hypochondrium pain. The physical examination showed blood pressure levels of 160/90 mmHg. An abdominopelvic CT evidenced left retroperitoneal haematoma associated with active bleeding and left renal artery stenosis. Given these findings, it was decided to perform an endovascular treatment. Significant stenosis was seen during the arteriography in both renal arteries, suggesting fibromuscular dysplasia and development of a collateral neovascular network responsible for the retroperitoneal haematoma. It was embolised in association with angioplasty of the left renal artery. The patient had a favourable outcome; however, high blood pressure levels persisted. A new bilateral renal angioplasty was performed, which returned blood pressure values to normal. The patient was discharged without needing antihypertensives. Conclusions FMD is a rare disease that can show multiple clinical presentations and need individualized treatment options. Endovascular techniques are in the first therapeutic line regarding fibromuscular dysplasia.
ISSN:2520-8934
2520-8934
DOI:10.1186/s42155-020-00157-8