Renal artery pseudoaneurysm and arteriovenous fistula to the inferior vena cava: A late complication following laparoscopic cholecystectomy

Major vascular injuries during laparoscopic procedures are rare but potentially life-threatening if not promptly diagnosed and treated. We report a case in which the placement of a trocar during a laparoscopic cholecystectomy caused damage to the right renal artery and led to the development of a pseudoaneurysm. The pseudoaneurysm of the right renal artery then eroded into the inferior vena cava resulting in an arteriovenous fistula that eventually caused right renal failure, systolic and diastolic hypertension, and congestive heart failure. The recognition of this complication was delayed and the patient was referred for surgery 5 years after the laparoscopic procedure. He then successfully underwent right nephrectomy, resection of the pseudoaneurysm, and closure of the fistula.