LAUSR

BACKGROUND Renal vein aneurysms (RVA)s are uncommon entities, which are usually incidental findings or may cause mild non specific symptoms. Modern radiological imaging, mainly multi slice computerized tomography (CT), has substantially contributed to a prompt and accurate diagnosis. Treatment may range from watchful waiting to aneurysmorraphy, aneurysmectomy and nephrectomy. Potential complications include thrombosis, pulmonary embolism, pressure to other structures and rupture. CASE A 58-year-old male patient was admitted at the Emergency Department with abdominal pain. He underwent an emergency computerized tomography (CT) which showed a huge retroperitoneal hematoma around the right kidney, while soon afterwards he entered a hypovolemic shock, less than an hour following a temporary loss of consciousness after an acute emotional distress episode. He underwent an emergency laparotomy and a right nephrectomy, due to a ruptured renal vein aneurysm (RVA). Interestingly, his postoperative course was uneventful and his six-month follow-up was normal. DISCUSSION This report presents the rupture of an RVA for the first time, which was successfully treated through nephrectomy by general surgeons in a secondary hospital. This is a catastrophic event which may be lethal, in case prompt diagnosis and surgical intervention delay. Due to the rarity of the disease, its etiology and optimal treatment remain to be clarified.