Published online Nov 16, 2023. doi: 10.12998/wjcc.v11.i32.7852
Peer-review started: July 8, 2023
First decision: August 24, 2023
Revised: September 6, 2023
Accepted: November 2, 2023
Article in press: November 2, 2023
Published online: November 16, 2023
Arterial bleeding typically involves the renal artery following partial nephrectomy; in this study, we present a case of bleeding originating from the testicular artery that has not been reported in previous studies.
A 52-year-old man suffered hemorrhage from a perinephric branch of the aberrant left testicular artery after an open nephron-sparing surgery for renal cell carcinoma. Clinical signs of bleeding were manifested by the patient, such as fresh blood drainage from the catheter, decreased hemoglobin levels, and significant vital sign changes. Since computed tomography did not show evidence of active bleeding, transcatheter angiography was conducted to identify the bleeding site. Fluoroscopic spot images confirmed bleeding derived from a perinephric branch of the testicular artery originating from the segmental artery of the left renal artery. Using n-butyl-2-cyanoacrylate, successful transcatheter arterial embolization of the affected branch was performed. Immediately after the embolization procedure, the bleeding ceased, and the patient experienced complete recovery devoid of complications.
In patients with postoperative arterial hemorrhage after partial nephrectomy, the testicular artery can be a rare but notable source of bleeding. Accurate bleeding site localization via angiographic evaluation, followed by transcatheter arterial embolization, can be instrumental for safe, prompt, and effective hemostasis.
Core Tip: Arterial hemorrhage, one of the complications associated with post partial nephrectomy, primarily arises from an injury to the distal end of the renal artery located at the kidney’s resection margin. Herein, we present a rare case of hemorrhage following partial nephrectomy that originated from a perinephric branch of the testicular artery, arising from the segmental artery of the renal artery. Despite the absence of active bleeding on computed tomography scan, preemptive angiographic evaluation based on a strong clinical suspicion of hemorrhage was performed. This afforded precise bleeding site identification, followed by successful transcatheter arterial embolization. It is noteworthy that arterial hemorrhage after partial nephrectomy can originate not only from the renal artery but also from the perinephric branches of nonrenal arteries, including the testicular artery.