Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 9-10, Pages: 644-647
https://doi.org/10.2298/SARH1210644S
Full text ( 245 KB)
Aortic dissection or renal infarction: Multislice computed tomographic angiography can tell
Stojanović Miloš (Institut za plućne bolesti Vojvodine, Sremska Kamenica)
Pena-Karan Slobodanka (Institut za plućne bolesti Vojvodine, Sremska Kamenica)
Joveš-Sević Biljana (Institut za plućne bolesti Vojvodine, Sremska Kamenica)
Ilić Tatjana (Klinika za nefrologiju i imunologiju, Klinički centar Vojvodine, Novi Sad)
Ilić Miroslav (Institut za plućne bolesti Vojvodine, Sremska Kamenica)
Introduction. Acute renal infarction as a consequence of renal artery
occlusion often goes unrecognized, mostly due to the non-specific clinical
features. A quick diagnosis, ideally within three hours of presentation, is a
key to renal function recovery. Case Outline. A 62-year-old male patient was
admitted with a sudden abdominal pain, right flank pain and nausea. He had a
diastolic hypertension at admission and his previous medical history showed
atrial fibrillation. Initial clinical diagnosis was aortic dissection.
Laboratory findings included elevated lactate dehydrogenase (LDH) and serum
creatinine levels. There were no signs of aortic dissection or aneurismatic
lesions registered during a multislice computed tomographic (MSCT)
angiography. However, MSCT angiography demonstrated left “upper” renal artery
thrombosis and renal infarction - avascular area of the upper two thirds of
the left kidney sharply demarcated from the surrounding parenchyma. Both
kidneys excreted the contrast. Anticoagulant therapy was initiated, along
with antiarrythmic and antihypertensive medications. The follow-up by
computed tomography was performed after nine weeks, and it showed a partial
revascularization of the previously affected area. Conclusion. Concomitant
presence of flank/abdominal pain, an increased risk for thromboembolism and
an elevated LDH suggested a possibility of renal infarction. MSCT angiography
is a non-invasive and accurate method in the diagnosis of renal artery
occlusion and the resulting renal infarction.
Keywords: renal infarction, computed tomography, angiography