Stent-Assisted Coiling of a Ruptured Renal Artery Aneurysm: an Unusual Cause of Low Back Pain

Renal artery aneurysms are rare, but their reported incidence has increased as a result of the widespread use of imaging techniques. Most aneurysms are asymptomatic and discovered incidentally; however, they can present with refractory hypertension, pain and hematuria. We report the case of a 42 year old normotensive woman who presented with acute lower back pain with unremarkable lumbar x rays, in the setting of acute anemia with hypotension, leading to a high suspicion for internal bleeding. CT scan of the abdomen and pelvis revealed the presence of a ruptured 1.8 cm right renal artery aneurysm. Successful exclusion of the aneurysm was accomplished by stent-assisted coiling. Follow up imaging at one and six month intervals revealed patency of the stent and no deleterious effects on renal function.