Renal artery aneurysm misdiagnosed as a pelvic stone: A case report

Int J Surg Case Rep. 2022 Apr:93:106826. doi: 10.1016/j.ijscr.2022.106826. Epub 2022 Feb 14.

Abstract

Introduction and importance: Renal artery aneurysm (RAA) is an extremely rare condition that is usually symptomless and may be diagnosed by a chance in imaging. However, misdiagnosis is not out of mind and few cases of misdiagnosis of RAA with renal stone have been reported. Misdiagnosis leads to wrong treatment, so it is very important for the correct diagnosis.

Case presentation: We reported a similar case in a 57 years old female that referred with right flank pain and ultrasonography and computed tomography (CT) scan reported a calcified mass, resembling renal stone. Through the operation the RAA was diagnosed; however, the mass was damaged and the patient underwent aneurysmectomy. Although she was a single kidney case, collateral circulation saved the kidney.

Clinical discussion: The patients may be asymptomatic or may present symptoms like treatment-resistant hypertension, hematuria, thrombosis, renal infarction, abdominal, or flank pain. As literature shows the diagnosis of RAA is challenging and affects patients' timely treatment. Our patient, who was a single kidney person, also survived the condition with no nephrectomy. The case of our study was single kidney and the collateral vessels give a further chance to kidney for survival. Although the affected artery was not further used, the collateral vessels circulation helped the kidney and the patient survived nephrectomy. She was discharged with a normal state and normal urination.

Conclusion: The timely diagnosis may help the patient with less invasive treatments.

Keywords: Aneurysm; Aneurysmectomy; Case report; Diagnostic errors; Renal artery; Tomography.