Bilateral common iliac artery aneurysms as cause of renal failure

Excerpt

A 71-year-old man with no relevant past medical history presented to the emergency department with asthenia. Serum biochemical parameters showed severe renal impairment. Renovesical ultrasound revealed normal sized kidneys with adequate cortical thickness and corticomedullary differentiation, with bilateral hydronephrosis. The bladder was slightly distended and an enlarged prostate gland was interpreted as the probable cause of the urinary tract obstruction. A bladder catheter was inserted and the patient was admitted to the intensive care unit. Dialysis therapy was initiated at day 1 since there was no evidence of renal function recovery. At day 6 the patient remained dialysis-dependent, proving that the enlarged prostate did not cause the obstruction. Ultrasound was again performed, continuing to show bilateral hydronephrosis with no imaging-based recovery. On this second ultrasound bilateral common iliac aneurysms were reported as a new finding. The patient underwent bilateral ureteral catheterization, and computed tomography (CT) confirmed the presence of bilateral common iliac aneurysms as the cause of bilateral urinary tract obstruction, compressing both ureters at this level (Fig. 1). The patient renal function registered a major recovery in the following days.

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