This case report illustrates how a life-threatening renal bleeding which has failed to be controlled by open surgery can be elegantly managed by a minimally invasive technique of interventional radiology. It also allows maximal conservation of renal tissue so that the patient can avoid chronic dialysis or renal transplantation.
A prospective study was performed on patients admitted to the medical and renal wards of General Hospital, Kuala Lumpur. Over a period of 14 months from 1 January 1982, 12 new cases of analgesic nephropathy (AN) were documented. Contrary to the experience in the West and in Australia, AN in Malaysia tends to have a male preponderance and occurs even in the younger age groups. The common analgesics abused are paracetamol, Chap Kaki Tiga and Chap Harimau. The main reasons for analgesic abuse are headache and arthritis. In addition to radiological features of renal papillary necrosis patients have the other manifestations of the disease such as peptic ulceration, anaemia, neuro-psychiatric disorders and ischaemic heart disease.