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Congenital arteriovenous fistula of the horseshoe kidney with multiple hemangiomas

Lazić Miodrag (Urološko odeljenje, Kliničko-bolnički centar „Dr Dragiša Mišović”, Beograd)
Hadži-Đokić Jovan (Srpska akademija nauka i umetnosti, Beograd)
Bašić Dragoslav (Urološka klinika, Klinički centar Niš, Niš)
Aćimović Miodrag (Klinika za urologiju i nefrologiju, Klinički centar Srbije, Beograd)

Introduction. Congenital renal arteriovenous fistulas (AVF) are rare, especially if they are associated with other developmental renal anomalies. Case Outline. A 34-year-old female was hospitalized due to total painless hematuria and bladder tamponade. Excretory urography revealed a horseshoe kidney with normal morphology of pyelocaliceal system and ureters. Aortography and selective renovasography detected a cluster-like vascular formation with multiple arteriovenous fistulas (AVF). Due to a large AVF gauge and poor flow of the efferent vein to the inferior vena cava, a surgical procedure of two renal artery segmentary branches ligation and division was performed. During the operative procedure, the presence of multiple superficial renal hemangiomas was detected. Conclusion. Although selective arterial embolization represents the preferable treatment option, conventional surgery remains favorable alternative in selected cases with large and complex AVF.

Keywords: congenital arteriovenous fistula, horseshoe kidney, multiple hemangiomas, selective arterial embolization, conventional surgery