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International Journal of Surgery & Surgical Procedures Volume 2 (2017), Article ID 2:IJSSP-127, 4 pages
https://doi.org/10.15344/2456-4443/2017/127
Case Report
Page Kidney Phenomenon following Kidney Graft Biopsy: A Medical Emergency

Jackie Mak1 and Bulang He2*

1General surgical department, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands 6009, Perth, Australia
2Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, School of Surgery, The University of Western Australia, Nedlands, Perth, WA 6009 Australia
Dr. Bulang He, Liver and Kidney Transplant Service, Sir Charles Gairdner Hospital, School of Surgery, The University of Western Australia, Nedlands, Perth, WA 6009, Australia; E-mail: bulang.he@health.wa.gov.au
30 August 2017; 26 October 2017; 30 October 2017
Mak J, He B (2017) Page Kidney Phenomenon following Kidney Graft Biopsy: A Medical Emergency. Int J Surg Surgical Proced 2: 127. doi: https://doi.org/10.15344/2456-4443/2017/127

Abstract

Percutaneous kidney allograft biopsy is commonly used for either diagnostic purpose or as a protocol to identify subclinical pathology. It is a safe procedure with a low incidence of the major complication. Page kidney phenomenon is one of rare complication following the biopsy, which will need urgent surgical intervention. Two cases in our cohort developed Page kidney phenomenon following percutaneous kidney allograft biopsy under US guidance. One case presented to the emergency department 10 days after biopsy with increased pain over the kidney graft, whereas another case developed symptoms during the observation period immediate post the biopsy. Both patients underwent emergency surgical exploration and haematoma evacuation. In the former case, the kidney graft was lost due to extensive haemorrhagic necrosis of the kidney parenchyma, while in the latter case, the kidney graft was salvaged with satisfactory function over 3 years follow up. In conclusion, the Page kidney phenomenon can occur spontaneously, following kidney biopsy or trauma in the setting of kidney transplant. Doppler ultrasound is a very useful modality for the diagnosis. Prompt surgical exploration and evacuation of the haematoma is fundamental in order to salvage the kidney graft.