Challenging differential diagnosis, Diagnostic / therapeutic accidents, Unusual setting of medical care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis), Rare co-existance of disease or pathology
Sihyung Park, Ga Hee Lee, Kyubok Jin, Kang Min Park, Yang Wook Kim, Bong Soo Park
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea
Am J Case Rep 2015; 16:832-836
Acute renal infarction is an uncommon condition resulting from an obstruction or a decrease in renal arterial blood flow. Isolated spontaneous renal artery intramural hematoma is a rare cause of renal infarction.
CASE REPORT: A 46-year-old healthy man presented to our emergency room because of sudden onset of severe right flank pain. An enhanced abdominal computed tomography scan showed a low-attenuated lesion in the lateral portion of the right kidney but no visible thromboembolisms in the main vessels. Computed tomography angiography revealed acute infarction resulting from intramural hematoma of the anterior segmental artery of the right kidney, with distal occlusion.
CONCLUSIONS: The rarity and non-specific clinical presentation of renal infarction often lead to a delayed diagnosis that may result in impaired renal function. Clinical suspicion is important in the early diagnosis, and intramural hematoma of the renal artery should be considered the cause of renal infarction even in healthy patients without predisposing factors.
Keywords: Aneurysm, Dissecting - diagnosis, Diagnosis, Differential, Hematoma - diagnosis, Infarction - etiology, Kidney - blood supply, Renal Artery, Tomography, X-Ray Computed