Home > Cases > Main Index > Case 14 | G.U. Index  

SRS-X The SRS Educational Resource

Case 14

Calcified arteriovenous fistula

Renal transplant recipient with haematuria

This 30 year old man had a history of mesangiocapillary glomerulonephritis 15 years earlier. He had suffered with severe hypertension ever since. He had had a renal transplant which had failed a few years ago, and was once again on dialysis. Five years earlier ring calcification had been noted over the right kidney on a plain film and a cystic calcified lesion was confirmed on ultrasound.

He recently experienced an episode of frank haematuria and a CT examination was requested to exclude a malignancy.

Findings

There is cystic change in the native kidneys, consistent with the changes seen after long term dialysis. There is a ring of calcification within the right kidney.

Following contrast the lesion enhances in a similar fashion to vascular structures. The right renal artery and vein are markedly dilated for a normal kidney, never mind an atrophic one.

Diagnosis

Calcified arteriovenous fistula following renal biopsy.

Discussion

This appearance is that of an arteriovenous fistula with a significant shunt. The plain film abnormality confirms that the lesion is long standing (over five years) and it almost certainly arose following a renal biopsy many years earlier.

Arteriovenous fistula is a well recognised complication of renal biopsy but rarely enlarges to this size.

Main Index  |   Previous Case

G.U. Index  |   Previous Case

Main Index as Unknowns

G.U. Index as Unknowns