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Case Reports
. 2014 May 22;4(2):103-8.
doi: 10.1159/000363224. eCollection 2014 May.

Renal infarction in a patient with pulmonary vein thrombosis after left upper lobectomy

Shun Manabe  1 , Yasuko Oshima  1 , Marie Nakano  1 , Teruhiro Fujii  1 , Takamitsu Maehara  2 , Kosaku Nitta  3 , Michiyasu Hatano  1
Affiliations
Case Reports

Renal infarction in a patient with pulmonary vein thrombosis after left upper lobectomy

Shun Manabe et al. Case Rep Nephrol Urol. .

Abstract

A 43-year-old male experienced renal infarction (RI) following left upper lobectomy for lung cancer. The patient complained of acute-onset severe left flank pain on the 14th postoperative day. A contrast-enhanced computed tomography (CT) of the abdomen revealed RI by a large wedge-shaped defect in the left kidney. A chest CT scan located the thrombus in the stump (a blind-ended vessel) of the left superior pulmonary vein. Therefore, thromboembolic RI caused by pulmonary vein thrombosis was suspected. Anticoagulation therapy was initiated with heparin and warfarin to treat RI and to prevent further embolic episodes. Two months later, pulmonary vein thrombosis had resolved without the appearance of additional peripheral infarction. This case emphasizes the need to consider thrombus in the stump of the pulmonary vein as a cause of RI.

Keywords: Lung cancer; Lung resection; Peripheral infarction; Pulmonary vein thrombosis; Renal infarction.

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Figures

Fig. 1
Fig. 1
a Preoperative CT of the chest reveals a nodular shadow in the upper lobe of the left lung (arrowhead). b Enhanced CT reveals a large wedge-shaped defect in the left kidney. c, d Enhanced CT after the diagnosis of renal infarction reveals a round defect in the stump of the left superior pulmonary vein (white arrow). e Enhanced CT 2 months after renal infarction reveals resolution of thrombosis (black arrow).
See this image and copyright information in PMC

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