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(A) Contrast enhanced CT scan shows a large, well-defined fluid collection (black arrow) measuring 47 x 68 x 101 mm posterosuperior to the residual lower pole fragment of the right kidney. (B) CT scan after placement of an 8 French percutaneous drainage catheter with a slight interval decrease in the size of the urinoma/hematoma.
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During her hospital course, her labs were significant for a persistently elevated WBC prompting further workup including a CT abdomen/pelvis with IV contrast on POD#13 which revealed a right kidney remnant isolated from the collecting system with a large, well-defined rim-enhancing collection (47 x 68 x 101 mm) posterior and superior to the residual lower pole fragment of right kidney with contrast visualized in the collection suggestive of a urinoma (Fig. 1).
(A) Arterial supply to kidney remnant. (B) Arterial supply to the kidney remnant is completely occluded with deployment of a 2 x 3 mm tornado microcoil. Two segmental arteries with traumatic pseudoaneurysms were embolized with 300-500 micron embospheres. Embolization left no residual blood flow within the right kidney fragment.
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Completion arteriogram demonstrated successful occlusion and zero blood flow within the kidney remnant (Fig. 2).