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Monday, 3 June 2013

CASE 192: AVM IN THE KIDNEY. Dr Nguyen Nghiep Van , Dr Nguyen Hoai Thu, Medic Medical Center, HCMC.

A 51 yo female patient suffered from hematuria for a few weeks. She went to Medic Center for abdominal ultrasound. Color Doppler of the abdomen detected an AVM at the upper pole of the right kidney, d= 4.6cm in diameter, which has aliasing inside and spectral waveform of AVM (see 2 images).

MSCT with CE detected A-V shunt at the upper pole of right kidney (see 3 images).

The patient underwent DSA to make sure AVM diagnosis. The right renal artery divides into 2 branches: the upper branch feeding for lower pole of the kidney, and the lower branch, for  the A-V shunt. This is not detected on the Angio MSCT ( see 3 images ).

Noted the IVC dilated and early filling contrast, therefore we decided not to treat by coiling, because the coil may move to right atrium. And the patient transmitted to Binh Dan hospital for nephrectomy.

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