Non-traumatic kidney rupture in a tuberosclerosis patient with renal angiomyolipomas

Tuberous sclerosis-associated renal angiomyolipoma: A report of two cases and review of the literature

In the general population, tuberous sclerosis-associated renal angiomyolipoma (RAML) is a rare benign hamartoma with potentially life-threatening complications and a poor prognosis. The two patients reported in the present study, who were diagnosed with bilateral RAML and spontaneous rupture of the RAML with tuberous sclerosis, presented with flank pain, abdominal pain, hemorrhage, hematuria and multiple lesions. The two cases are representative examples of the disease, and highlight the importance of determining the risk of acute hemorrhage in the early stages, and the significance of timely and proper treatment.

Traumatically shattered kidney without urine extravasation or vascular amputation

The American Association for the Surgery of Trauma (AAST) injury scoring scale is commonly used for genitourinary injuries. Normally, grade 4-5 lacerations of the kidney show involvement of the pelvicalyceal system (PCS) with urine extravasation (UE). We present a case of a 41-year-old woman who was hospitalised with macrohaematuria and retroperitoneal haematoma after severe blunt acceleration flank trauma. CT scan showed an extended laceration of the left kidney with separation of upper pole. This is the first case of an extended kidney laceration without UE due to rupture within the dichotomous PCS, which healed up after selective embolisation. If possible, severe renal bleeding should be treated with selective embolisation as an alternative to surgery. Any suspected involvement of the PCS should undergo retrograde ureteropyelography and urinary diversion.