| A 19-year-old male patient came to the emergency department after a motor vehicle traffic accident. | |
| She had no urological history. | |
| The patient complained of severe abdominal pain. | |
| Physical examination revealed a Glasgow Coma Scale of 15 points, with a painful mass in the left upper quadrant associated with significant abdominal disfunction. | |
| He had macrohematuria at spontaneous micturition. | |
| The patient remained silently stable at all times, but during the initial evaluation the hematocrit dropped 10 points. | |
| Contrast-enhanced computed tomography (CT) revealed a horseshoe kidney with a fracture in the junction zone between the lower pole of the left kidney and the isthmus, showing active hemorrhage and extensive retroperitoneal hematoma (10x7x23 cm). | |
| Delayed sections showed contrast extravasation compatible with an important urinoma. | |
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| An arteriography was performed, showing a double dye compatible with each kidney and a common distal lumborenal trunk that gave accessory branches to the lower poles of both kidneys and the isthmus with active contrast extravasation. | |
| The lumborenal trunk was selectively catheterized, aiming at the branch of the left kidney and isthmus allowing its embolization with polyvinyl alcohol particles, without immediate complications. | |
| The urinary tract was catheterized retrogradely with a ureteral catheter to facilitate the drainage of the urinoma. | |
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| In the following days, the patient was asymptomatic with complete resolution of the pain and hematuria, with stable leakage and a control CT that showed no signs of bleeding, with complete resolution of the urinoma and no signs of urinoma. | |
| Three months after embolization, control CT showed complete resolution of the hematoma. | |
| There were no late complications, maintaining normal renal function and blood pressure at 12 months follow-up. | |