Isolated renal artery thrombosis because of blunt trauma abdomen: report of a case with review of the literature

Abstract

Background: Isolated renal trauma in case of blunt trauma abdomen (BTA) is not common. Renal artery occlusion by thrombosis in such cases is seen very rarely. These cases had been traditionally treated by early nephrectomy, but nowadays, renal preservation is considered whenever possible. Treatment options to do so are being developed.

Methods: Recently we came across one such case of isolated unilateral renal artery thrombosis (RAT) because of BTA. Relevant literature especially on various therapeutic techniques has been critically reviewed briefly along with case presentation.

Results: Isolated blunt traumatic RAT has an incidence of less than 1%. Only about 400 cases have been reported. It must be diagnosed and treated as soon as possible to avoid progressive permanent loss of renal function. Contrast-enhanced CT scanning is the preferred modality for evaluation and follow-up of RAT. Conservative treatment is reserved for unilateral cases. For bilateral cases and when RAT occurs in a solitary kidney, revascularization either surgically or more preferably by less invasive percutaneous techniques has been recommended.

Conclusion: Renal arterial thrombosis because of blunt abdominal trauma is still an underreported entity, treatment for which has not yet been established. Both early nephrectomy and delayed revascularization are not justified treatment options.