Active bleeding after kidney biopsy: Successful ultrasound-guided direct thrombin embolization into the cortical fistula

J Clin Ultrasound. 2021 May;49(4):390-394. doi: 10.1002/jcu.22939. Epub 2020 Oct 24.

Abstract

A 27-year-old man, previously diagnosed with IgA nephropathy, was referred for native kidney biopsy. After the procedure, the patient presented active bleeding revealed by Doppler and contrast-enhanced ultrasonography at the biopsy site. Successful embolization of the cortical fistula, the focus of bleeding, was achieved using ultrasound-guided thrombin injection and confirmed by Doppler ultrasonography, contrast-enhanced ultrasonography, and CT angiography. This case report shows that contrast-enhanced ultrasonography is useful for detecting active bleeding after a solid organ biopsy. Moreover, ultrasound-guided thrombin embolization is a safe and minimally invasive treatment and an alternative to angiography-guided embolization.

Keywords: contrast-enhanced ultrasonography; kidney biopsy; thrombin embolization; ultrasonographic guidance.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aneurysm, False / diagnostic imaging
  • Aneurysm, False / etiology
  • Aneurysm, False / therapy*
  • Angiography / methods
  • Biopsy / adverse effects*
  • Embolization, Therapeutic / methods*
  • Hematoma / diagnostic imaging
  • Hematoma / etiology
  • Hematoma / therapy*
  • Hemorrhage / diagnostic imaging
  • Hemorrhage / etiology
  • Hemorrhage / therapy*
  • Humans
  • Kidney / blood supply
  • Kidney / pathology
  • Kidney Diseases / diagnostic imaging
  • Kidney Diseases / etiology
  • Kidney Diseases / therapy*
  • Male
  • Thrombin / administration & dosage*
  • Ultrasonography, Interventional / methods

Substances

  • Thrombin