Perirenal hematoma - post biopsy

Discussion:

Hemorrhage and hematoma are a risk in percutaneous renal biopsy, even if the patient has no specific risk factors. Small hematomas are common (~90% in one series), but large hematomas are uncommon.

Blood products in the abdomen start at blood pool attenuation. Then, as they age and the hemoglobin concentrates, the hematoma increases in attenuation (up to 60-80 HU). As the hematoma ages and becomes a seroma, the attenuation drops back to around 30 HU.

If the cause of a renal/perirenal hematoma is known (such as biopsy), then further imaging is not necessary unless the patient is not clinically improving and there is concern for an expanding hematoma. If the patient does not have a reason for the hematoma, then one should be concerned about an underlying mass that is hemorrhaging. The patient should return after resolution of the hemorrhage to assess for an underlying mass with contrast enhanced CT or MRI.

    Create a new playlist
Loading...