{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:45:56Z","timestamp":1792143956395,"version":"4.4.0"},"reference-count":15,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Spontaneous development of vesical artery pseudoaneurysm (VA\u2010PA) as a cause of life\u2010threatening hematuria is very rare. Most of the existing reports are due to trauma or other types of pelvic surgeries\/urological procedures. Incomplete hemostasis in these patients can lead to subsequent complications such as clot retention, severe blood loss resulting in anemia and obstructive AKI. We report this extremely rare case of a 35\u2009year old lady with bilateral VA\u2010PA causing recurrent episodes of massive hematuria and obstructive AKI that was ultimately resolved by selective embolization. A 35\u2010year\u2010old female presented with a history of gross hematuria along with clot retention and severe anemia. She also had signs of obstructive AKI which required her to have temporary dialysis. Cystoscopy showed intravesical clot but no bleed site was identified on initial evaluation. On contrast\u2010enhanced CT scan, there were pseudoaneurysms found from both sides coming off from left superior and right inferior branches of vesical artery. Following confirmation by selective pelvic angiogram, we did a superselective embolization using micro coils and PVOH particles to occlude both pseudoaneurysms. This resulted in immediate cessation of hematuria, normalization of renal functions and stabilization of Hb values. At last follow\u2010up done in 6\u2009weeks' time, all symptoms had resolved and there was complete thrombosis of both the lesions seen on imaging. Bilateral spontaneous vesical artery pseudoaneurysm is a condition that must be suspected in a patient presenting with recurrent episodes of severe hematuria despite having undergone seemingly successful endoscopic treatment. Immediate imaging of the vessels and selective angioembolization is the surest means of diagnosis and treatment, thus avoiding further complications.<\/jats:p>","DOI":"10.1002\/ccr3.73739","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:04:05Z","timestamp":1792141445000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous Bilateral Vesical Artery Pseudoaneurysms Presenting With Massive Recurrent Hematuria and Obstructive Acute Kidney Injury: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3424-5979","authenticated-orcid":false,"given":"Dheeraj Kumar Alias","family":"Sailish","sequence":"first","affiliation":[{"name":"Ghulam Muhammad Mahar Medical College  Sukkur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amisha","family":"Kumari","sequence":"additional","affiliation":[{"name":"Ghulam Muhammad Mahar Medical College  Sukkur Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2989-8573","authenticated-orcid":false,"given":"Hadia","family":"Jamil","sequence":"additional","affiliation":[{"name":"Niazi Welfare Teaching Hospital  Sargodha Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sardar Ravi","family":"Singh","sequence":"additional","affiliation":[{"name":"Liaquat University of Medical and Health Sciences  Jamshoro Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1800-1800","authenticated-orcid":false,"given":"Muhammad Hassaan","family":"Javaid","sequence":"additional","affiliation":[{"name":"Shifa College of Medicine  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0717-2777","authenticated-orcid":false,"given":"Muddassir","family":"Khalid","sequence":"additional","affiliation":[{"name":"Nishtar Medical University, Nishtar Hospital Multan  Multan Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7441-9135","authenticated-orcid":false,"given":"Fred","family":"Segawa","sequence":"additional","affiliation":[{"name":"Makerere University College of Health Sciences  Kampala Central Region Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"issue":"1","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1148\/rg.25si055503","article-title":"Pseudoaneurysms and the Role of Minimally Invasive Techniques in Their Management","volume":"25","author":"Saad N. E.","year":"2005","journal-title":"Radiographics"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/1471-2490-13-68","article-title":"Severe Hematuria After Transurethral Electrocoagulation in a Patient With an Arteriovesical Fistula","volume":"13","author":"Zheng X.","year":"2013","journal-title":"BMC Urology"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/s13256-021-02668-x","article-title":"Frank Haematuria Secondary to Ruptured Pseudoaneurysm of the Inferior Vesical Artery: A Case Report and Review of the Literature","volume":"15","author":"Suoub M.","year":"2021","journal-title":"Journal of Medical Case Reports"},{"issue":"4","key":"e_1_2_12_5_1","article-title":"Femoral Pseudoaneurysm Rupturing Into Urinary Bladder: A Rare Presentation","volume":"2015","author":"Shrestha K. R.","year":"2015","journal-title":"Journal of Surgery Case Reports"},{"issue":"5","key":"e_1_2_12_6_1","first-page":"38","article-title":"The CARE Guidelines: Consensus\u2010Based Clinical Case Reporting Guideline Development. Glob Adv","volume":"2","author":"Gagnier J. J.","year":"2013","journal-title":"Health & Medicine"},{"issue":"2","key":"e_1_2_12_7_1","article-title":"Obstructive Uropathy: Overview of the Pathogenesis, Etiology and Management of a Prevalent Cause of Acute Kidney Injury. World","volume":"13","author":"P\u00e9rez\u2010Aizpurua X.","year":"2024","journal-title":"Journal of Nephrology"},{"issue":"1","key":"e_1_2_12_8_1","first-page":"1","article-title":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"2","year":"2012","journal-title":"Kidney International. 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J.","year":"2020","journal-title":"Journal of Hepatology"},{"issue":"2","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.aju.2018.01.004","article-title":"Selective Embolisation for Intractable Bladder Haemorrhages: A Systematic Review of the Literature","volume":"16","author":"Taha D. E.","year":"2018","journal-title":"Arab Journal of Urology"},{"issue":"5","key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"1947","DOI":"10.1016\/j.juro.2010.01.003","article-title":"Outcome of Transcatheter Arterial Embolization for Bladder and Prostate Hemorrhage","volume":"183","author":"Delgal A.","year":"2010","journal-title":"Journal of Urology"},{"issue":"9","key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1177\/0284185120952781","article-title":"Superselective Vesical Artery Embolization for Intractable Bladder Hemorrhage Related to Pelvic Malignancy","volume":"62","author":"Kim M. S.","year":"2021","journal-title":"Acta Radiologica"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73739","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73739","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73739","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:04:08Z","timestamp":1792141448000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73739"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":15,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/ccr3.73739"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73739","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73739"}}