0:00

So this is a patient who is post-op day

0:03

one or two from a renal transplant actually

0:06

got a pediatric on block. We don't transplant and so we were looking at

0:09

the transplanted kidneys to ensure that there were no complications. And

0:12

so we look at on the grayscale image. You can see one of the transplants over

0:15

here and we can certainly scroll through and see our

0:18

evaluation of both renal transplants.

0:22

And we certainly do our color Doppler evaluation as well

0:25

as a little bit of fluid associated with the lower pole

0:28

of some of these transplants. But as you sort of scroll through the set

0:31

of images one thing that will become clear right

0:34

around here is that there's a large collection Associated

0:37

or adjacent to these transplants.

0:40

You can start to see it over here. And as

0:43

you scroll through it see how big it becomes you scroll

0:46

through it again, you can see that it's actually quite quite large

0:49

over here and the more you scroll the more you realize that this is

0:52

quite a large collection that is surrounding sort

0:55

of more medial of the two on block renal transplants.

1:00

In terms of which Imaging characteristics this beautifully demonstrate what

1:03

we call a fluid hematocrit level where some of the blood

1:06

products are sort of layering within this more dependently.

1:11

You know within this large collection and so this appearance is

1:14

quite classic for a hematoma and

1:17

hematomas can occur really at any time, but you're

1:20

most often going to see them in the postoperative setting it can

1:23

also curve post biopsy.

1:25

When they're small they sort of spontaneously resolved. We don't

1:28

worry about them too much but we start to worry about them when they're large.

1:31

They're getting larger.

1:34

Sometimes if there's some capsular they can result in significant Mass

1:37

Effect upon the kidney resulting in page kidney

1:40

physiology.

1:42

Some vascular compromise and so, you know as innocuous as

1:45

it may seem to just have a post-operative hematoma. It's important

1:48

to sort of follow these and make sure that their resolve

1:51

over time. You can see over here how beautiful it looks

1:54

and this instance the hematoma.

1:57

Hematomas can also have Mass Effect depending on where they

2:00

are upon the vessels resulting in renal arteries to gnosis or potentially

2:03

narrowing of the renal vein. And so

2:06

You know, certainly these are some things depending on

2:09

the size. Maybe you need to be aspirated if they're causing some

2:12

compromise of the real transplant and

2:15

this is just a color image showing that indeed. This is a hematoma.

2:18

There's no flow within this collection over

2:21

here.