Delayed Renal Artery Pseudoaneurysm Rupture After Pediatric Blunt Renal Trauma: A Case Report

Introduction: Renal artery pseudoaneurysm (RAP) is an uncommon but potentially life-threatening delayed complication of pediatric blunt renal trauma. High-grade injuries may appear stable initially, making late presentation challenging to detect.Case Report: A 10-year-old boy sustained a grade IV right renal injury after a motorcycle collision and was successfully managed conservatively, with resolution of hematuria before discharge. Four weeks later, he re-presented with recurrent hematuria, anemia, and flank pain. CT imaging revealed an actively bleeding segmental pseudoaneurysm with an enlarging perinephric hematoma. Urgent angioembolization and hematoma drainage were performed, resulting in rapid stabilization and preservation of renal function.Conclusion: Delayed RAP rupture may occur weeks after apparent recovery from high-grade renal trauma. Recurrent hematuria or unexplained anemia should prompt urgent imaging. Early diagnosis and angioembolization are essential to prevent catastrophic hemorrhage and optimize renal salvage in pediatric patients.