Congenital arteriovenous fistula of the horseshoe kidney with multiple hemangiomas

SUMMARy Introduction Congenital renal arteriovenous fistulas (AVF) are rare, especially if they are associated with other developmental renal anomalies. Case Outline A 34­y ear­o ld female was hospitalized due to total painless hematuria and bladder tam­ ponade. Excretory urography revealed a horseshoe kidney with normal morphology of pyelocaliceal system and ureters. Aortography and selective renovasography detected a cluster­li ke vascular forma­ tion 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, con­ ventional surgery remains favorable alternative in selected cases with large and complex AVF. k eywords: congenital arteriovenous fistula; horseshoe kidney; multiple hemangiomas; selective arte­ rial embolization; conventional surgery