Annals of Vascular Surgery

, Volume 10, Issue 4, pp 370–372 | Cite as

Ruptured renal artery aneurysm during pregnancy

  • Jack C. Yang
  • Robert J. Hye
Papers Presented At The Southern California Vascular Surgical Society


A 38-year-old woman (gravida 4, para 1) underwent arteriography at 19 weeks' gestation after two exploratory laparotomies had failed to identify a source of retroperitoneal and intra-abdominal hemorrhage. The arteriogram demonstrated a large right renal artery aneurysm (RAA) and a very small left RAA. Emergency repair of the aneurysm was attempted but was impossible, so a right nephrectomy was performed. The fetus had died prior to arteriography and a cesarean section was performed concomitantly. The postoperative course was unremarkable. RAAs are rare and usually asymptomatic, but pregnancy is associated with a higher risk of rupture. Prior to 1970, reported rupture occurred most often on the left side, during the third trimester, and was associated with a 92% maternal mortality and a 100% fetal mortality rate. Since 1970, published reports have not shown a left-sided predominance, and survival after this catastrophic event has greatly improved, even though preoperative diagnosis is still rare. The possibility of a ruptured RAA should be considered in pregnant women with evidence of retroperitoneal hemorrhage. Arterial repair should be attempted but has not been feasible in most cases. This case was unusual because it occurred during the second trimester of pregnancy. Recent cases and technical considerations regarding repair are discussed.


Public Health High Risk Mortality Rate Pregnant Woman Cesarean Section 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Cohen JR, Shamash FS. Ruptured renal artery aneurysms during pregnancy. J Vasc Surg 1987;6:51–59.Google Scholar
  2. 2.
    Hidai H, Kinoshita Y, Murayama T, et al. Rupture of renal artery aneurysm. Eur Urol 1985;11:249–253.Google Scholar
  3. 3.
    Nolte JE, Rutherford RB, Nawaz S, et al. Arterial dissections associated with pregnancy. J Vasc Surg 1995;21:515–520.Google Scholar
  4. 4.
    Tham G, Ekelund L, Herrlin K, et al. Renal artery aneurysms, natural history and prognosis. Ann Surg 1983;197:348–352.Google Scholar
  5. 5.
    Henriksson C, Bjorkerud S, Nilson AE, et al. Natural history of renal artery aneurysm elucidated by repeated angiography and pathoanatomical studies. Eur Urol 1985;11:244–248.Google Scholar
  6. 6.
    Martin RS, Meacham PW, Ditesheim JA, et al. Renal artery aneurysm: Selective treatment for hypertension and prevention of rupture. J Vasc Surg 1989;9:26–34.Google Scholar
  7. 7.
    Rijgbroek A, Dijk HAV, Roex AJM. Rupture of renal artery aneurysm during pregnancy. Eur J Vasc Surg 1994;8:375–376.Google Scholar
  8. 8.
    Whiteley MS, Katoch R, Kennedy RH, et al. Ruptured renal artery aneurysm in the first trimester of pregnancy. Eur J Vasc Surg 1994;8:238–239.Google Scholar
  9. 9.
    Schoon IM, Seeman T, Niemand D, et al. Rupture of renal arterial aneurysm in pregnancy. Acta Chir Scand 1988;154:593–597.Google Scholar
  10. 10.
    Bulbul MA, Farrow GA. Renal artery aneurysms. Urology 1992;40:124–126.Google Scholar
  11. 11.
    Love WK, Robinette MA, Vernon CP. Renal artery aneurysm rupture in pregnancy. J Urol 1981;126:809.Google Scholar
  12. 12.
    Dayton DB, Helgerson RB, Sollinger HW, et al. Ruptured renal artery aneurysm in a pregnant uninephric patient: Successful. ex vivo repair and autotransplantation. Surgery 1990;107:708–711.Google Scholar
  13. 13.
    Chen R, Novick AC. Retroperitoneal hemorrhage from a ruptured renal artery aneurysm with spontaneous resolution. J Urol 1994;151:139–141.Google Scholar
  14. 14.
    Savastano S, Feltrin GP, Miotto D, et al. Renal artery aneurysm and arteriovenous fistula: Management with transcatheter embolization. Acta Radiol 1990;31:73–76.Google Scholar
  15. 15.
    Marin ML, Veith FJ, Panetta TF, et al. Transluminally placed endovascular stented graft repair for arterial trauma. J Vasc Surg 1994;20:466–473.Google Scholar

Copyright information

© Annals of Vascular Surgery Inc. 1996

Authors and Affiliations

  • Jack C. Yang
    • 1
  • Robert J. Hye
    • 1
  1. 1.Department of SurgeryUCSD Medical CenterSan Diego

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