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Case Reports
. 2015 Nov 24:16:832-6.
doi: 10.12659/ajcr.895285.

Renal Infarction Caused by Isolated Spontaneous Renal Artery Intramural Hematoma

Sihyung Park  1 , Ga Hee Lee  1 , Kyubok Jin  1 , Kang Min Park  2 , Yang Wook Kim  1 , Bong Soo Park  1
Affiliations
Case Reports

Renal Infarction Caused by Isolated Spontaneous Renal Artery Intramural Hematoma

Sihyung Park et al. Am J Case Rep. .

Abstract

Background: 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.

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Figures

Figure 1.
Figure 1.
The abdominopelvic computed tomography (horizontal view) reveals perfusion defects, which sharply demarcated a low attenuated lesion in the lateral portion of the right kidney (arrow). No clearly visible thromboembolism in main vessels (bold arrow).
Figure 2.
Figure 2.
The multidetector computed tomography angiography reveals intramural hematoma of anterior segmental artery of right kidney, with distal occlusion (arrow). (A: coronal, B: horizontal, C: 3D and maximal intensity projection image).
Figure 3.
Figure 3.
The abdominopelvic computed tomography (A: horizontal view, B: coronal view) reveals interval decreased volume of infarcted necrotic parenchyme, right kidney (about 40% involvement).
See this image and copyright information in PMC

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