A 19-year-old male was involved in a high-speed motor vehicle accident. He sustained multiple traumatic injuries including skeletal fractures, a pulmonary contusion, grade 1 splenic injury, grade 3 right renal laceration and grade 4 left renal laceration with partial ureteropelvic junction disruption. He underwent open reduction/internal fixation of the left tibia/fibula fracture and a left indwelling ureteral stent was placed. The remaining injuries were treated nonoperatively and he was discharged home on hospital day 8. The patient was rehospitalized 8 days later with a left leg surgical wound infection. On readmission he-matocrit decreased from 30.3 to 16.7. He received a transfusion of 4 units of packed red blood cells and computerized tomography of the abdomen/pelvis revealed a 4.8 cm left renal artery pseudoaneurysm (part A of figure).
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