Chun Chau TAN, Zi Hui TAN
Journal of Emergency Medicine Case Reports - 2026;17(2):75-78
Renal artery pseudoaneurysm (RAP) is an uncommon but potentially life-threatening delayed complication of pediatric blunt renal trauma. High-grade injuries may appear stable initially, making late presentation challenging to detect. A 10-year-old boy sustained a grade IV right renal injury after a motorcycle collision and was successfully initially managed non-operatively, with resolution of gross hematuria before discharge. Four weeks later, he re-presented with recurrent hematuria, anemia, and flank pain. Computed Tomography (CT) imaging revealed an actively bleeding segmental pseudoaneurysm with an enlarging perinephric hematoma. Urgent angioembolization and hematoma drainage were performed, resulting in hemodynamic stabilization and preservation of renal function. Delayed RAP rupture may occur weeks after apparent recovery from high-grade renal trauma. Recurrent hematuria or unexplained anemia should prompt urgent vascular imaging. Early diagnosis and transcatheter angioembolization are essential to prevent catastrophic hemorrhage and optimize renal salvage in pediatric patients.
