Spontaneous renal artery dissection: an elusive diagnosis

2021 ◽  
Vol 14 (9) ◽  
pp. e245949
Author(s):  
Catherine Mary Henry ◽  
Peter MacEneaney ◽  
Gemma Browne
Keyword(s):  
Renal Artery ◽  
Antihypertensive Treatment ◽  
Rare Condition ◽  
Acute Onset ◽  
Flank Pain ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Ct Angiogram ◽  
Systemic Anticoagulation ◽  
The Right

Spontaneous renal artery dissection is a rare condition with an often non-specific presentation, resulting in a challenging diagnosis for clinicians. This is the case of a 39-year-old man who presented with an acute-onset right flank pain, mild neutrophilia and sterile urine. CT of abdomen and pelvis showed a patchy hypodense area in the right kidney originally thought to represent infection. He was treated as an atypical pyelonephritis with antibiotics and fluids. When his symptoms failed to improve, a diagnosis of renal infarction was considered and CT angiogram of the aorta revealed a spontaneous renal artery dissection. He was managed conservatively with systemic anticoagulation, antihypertensive treatment and analgesia and discharged home with resolution of his symptoms and normal renal function.

scholarly journals Isolated Spontaneous Renal Artery Dissection Presented with Flank Pain

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Shruti P. Gandhi ◽  
Kajal Patel ◽  
Bipin C. Pal
Keyword(s):  
Computed Tomography ◽  
Renal Artery ◽  
Ct Angiography ◽  
Final Diagnosis ◽  
Flank Pain ◽  
Vascular Pathology ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Doppler Study ◽  
Main Renal Artery

Spontaneous renal artery dissection is a rare but important cause of flank pain. We report a case of isolated spontaneous renal artery dissection in 56-year-old man complicated by renal infarction presented with flank pain. Doppler study pointed towards vascular pathology. Computed tomography (CT) angiography was used to make final diagnosis which demonstrated intimal flap in main renal artery with renal infarction.

scholarly journals MO173SPONTANEOUS RENAL ARTERY DISSECTION (SRAD): IS IT REALLY SO RARE?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Fausta Catapano ◽  
Maria Cristina Galaverni ◽  
Simone NIcoletti ◽  
Elena Mancini
Keyword(s):  
Renal Artery ◽  
Antihypertensive Drugs ◽  
Oral Anticoagulants ◽  
Renal Outcome ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Non Invasive ◽  
Underlying Causes ◽  
Systemic Anticoagulation

Abstract Introduction. Spontaneous Renal Artery Dissection (SRAD) is a rare and often unrecognized clinical entity, which only accounts for 1-2% of all arterial dissections. Due to its rarity, it may be difficult to diagnose and treat. Methods. All patients affected by SRAD and admitted in our Unit in the last year were included. Results. Five patients presented with renal infarction due to SRAD were admitted in our Unit in 2020. Patient Characheristics are shown in Table 1. At onset, all suffered from abdominal pain and high blood pressure. In all patients renal function was normal. Abdomen computed tomography angiography (CTA) was diagnostic in all patients (Figure 1). They were treated with antihypertensive drugs and systemic anticoagulation followed by oral anticoagulants. At 3 month-follow-up, all patients became normotensive and partial or total renal artery recanalization were found (Figure 2). Conclusions. In our experience, SRAD seems to be not very rare in young and healthy patients with minimal comorbidities. Abdomen CTA is one of the “gold standard” non invasive diagnostic method. In patient treated with conservative medical therapy renal outcome is favourable. More studies are necessary to find underlying causes.

Renal Infarction and Pulmonary Embolism in Patient with Myelodysplastic

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mounia Bendari ◽  
Nouama Bouanani ◽  
Mohamed Amine Khalfaoui ◽  
Maryam Ahnach ◽  
Aziza Laaraj ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Myeloproliferative Neoplasms ◽  
Bone Biopsy ◽  
Bone Marrow Aspiration ◽  
Myeloproliferative Disorders ◽  
Acute Onset ◽  
International Prognostic Scoring System ◽  
Renal Infarction ◽  
The Right ◽  
Enhanced Computed Tomography

The myelodysplastic syndrome-myeloproliferative neoplasms (MDS/MPNs) are defined by a group of heterogeneous hematological malignancies resulting from stem cell−driven clonal growth of pathological hematopoietic progenitors and ineffective hematopoiesis, they are characterized concomitant myelodysplastic and myeloproliferative signs. Myelodysplastic/myeloproliferative disorders have been considered to have a higher risk of thrombus formation.We report a rare case about a 64 years old Moroccan woman, experienced renal infarction (RI) associated with pulmonary embolism as a complication of a myelodysplastic/myeloproliferative disorder.The patient complained of acute-onset severe left flank pain, a contrast-enhanced computed tomography (CT) of the chest and abdomen revealed RI by a large wedge-shaped defect in the right kidney with pulmonary embolism.Biological exam showed deep anemia, the bone marrow aspiration found myelodysplasia.the bone biopsy showed signs of myeloproliferatif disease. The karyotype was normal, BCR-ABL, JAK2, CALR mutations were absents, and MPL mutation was positive. The International Prognostic Scoring System (IPSS-R) was 0, and the patient was included to the low risk group.Anticoagulation therapy was initiated with heparin to treat RI and pulmonary embolism. Three months later, pulmonary embolism had resolved without the appearance of additional peripheral infarction.This case emphasizes the need to consider myelodysplastic/myeloproliferative disorders as a cause of infraction renal and pulmonary embolism.

scholarly journals Cerebellar infarction after sneezing

2020 ◽  
Vol 66 (10) ◽  
pp. 1351-1354
Author(s):  
Gustavo Bittencourt Camilo ◽  
Marco Antônio Riccio ◽  
Anna Luíza Machado Nogueira ◽  
Amanda Campos Querubino ◽  
Ana Luísa dos Santos Maciel ◽  
...  
Keyword(s):  
Vertebral Artery ◽  
Lumbar Disc ◽  
Vertebral Artery Dissection ◽  
Rare Condition ◽  
Artery Dissection ◽  
Cerebellar Infarction ◽  
Herniated Lumbar Disc ◽  
Angio Ct ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

SUMMARY Vertebral Artery Dissection (VAD) is a rare condition that can be caused by a wide amplitude of neck movement, which injures the vessel wall and can cause ischemia in the cerebellum. We present a 37-year-old man with herniated lumbar disc and allergic rhinosinusitis, which caused sneezing spells. After one of these bouts with a ricochet of the head, he presented C3 misalignment with local pain. Twenty-one days later, affected by a new crisis, he presented left temporal headache, nystagmus, and vertigo. After 3 days, Magnetic Resonance Imaging (MRI) identified 2 regions of cerebellar ischemia and filling failure of the right vertebral artery. After 2 days, Computed Angiotomography (CT Angiography) was performed and showed right VAD with a local thrombus, without aneurysmal signs. Transcranial Doppler did not indicate an increase in blood flow from this artery. The suggested treatment involved administration of anticoagulant Apixabana 5mg, 12/12h, for 3 months, until the condition was reevaluated with new Angio CT and MRI. It was recommended that the patient was released from work for 1 month and forbidden from doing intense physical exercises for 3 months; however, due to setbacks, these deadlines were extended until a new appointment, 4 months after the first visit. The new tests showed no changes, indicating that the condition was stable. This case aims to indicate the possible investigations of the diagnosis and therapeutic options of the rare association between VAD with cerebellar infarction in a well-documented case.

scholarly journals Spontaneous Renal Artery Dissection as a Cause of Acute Renal Infarction: Clinical and MDCT Findings

2017 ◽  
Vol 32 (4) ◽  
pp. 605 ◽  
Author(s):  
Kibo Yoon ◽  
Soon-Young Song ◽  
Chang Hwa Lee ◽  
Byung-Hee Ko ◽  
Seunghun Lee ◽  
...  
Keyword(s):  
Renal Artery ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Acute Renal Infarction

Renal Artery Dissection Causing Renal Infarction in Otherwise Healthy Men

1998 ◽  
Vol 160 (3 Part 1) ◽  
pp. 953-954
Author(s):  
A. Alamir ◽  
D.F. Middendorf ◽  
P. Baker ◽  
N.S. Nahman ◽  
A.B. Fontaine ◽  
...  
Keyword(s):  
Renal Artery ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Healthy Men

scholarly journals Renal infarction resulting from traumatic renal artery dissection

2008 ◽  
Vol 23 (2) ◽  
pp. 103-105 ◽  
Author(s):  
Kyung Pyo Kang ◽  
Sik Lee ◽  
Won Kim ◽  
Gong Yong Jin ◽  
Ki Ryang Na ◽  
...  
Keyword(s):  
Renal Artery ◽  
Artery Dissection ◽  
Renal Infarction

scholarly journals Intravenous tPA in the treatment of acute stroke related to aortic dissection

2019 ◽  
Vol 12 (6) ◽  
pp. e229982
Author(s):  
Vikram Shivkumar ◽  
Dipali Nemade
Keyword(s):  
Aortic Dissection ◽  
Cerebral Hemisphere ◽  
Acute Onset ◽  
Medical Illness ◽  
Not Given ◽  
Ct Angiogram ◽  
Right Cerebral Hemisphere ◽  
Tissue Plasminogen ◽  
The Right ◽  
Time Of Presentation

A 61-year-old woman with no prior medical illness presented with acute onset stroke symptoms. She had no chest pain at the time of presentation. However, CT angiogram showed an extensive aortic dissection, resulting in hypoperfusion of the right cerebral hemisphere and thus causing stroke symptoms. Due to this finding, tissue plasminogen activator was not given and a negative outcome was avoided.

scholarly journals Symptomatic Infundibulopelvic Dysgenesis in an Adolescent

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Pitts ◽  
David Chalmers ◽  
Brian Jumper
Keyword(s):  
Complete Resolution ◽  
Left Kidney ◽  
Rare Condition ◽  
Renal Calculi ◽  
Flank Pain ◽  
Pelvicalyceal System ◽  
Retrograde Pyelogram ◽  
History Of ◽  
The Right ◽  
Collecting System

Infundibulopelvic dysgenesis is a rare condition characterized by congenital malformation of the pelvicalyceal system. We present the case of an 18-year-old boy with chronic intermittent right flank pain and cystic dilation with parenchymal thinning on ultrasonography. The left kidney was normal. The patient denied dysuria, constipation, and history of UTIs or renal calculi. Cystoscopy with retrograde pyelogram showed marked stenosis of the right pelvicalyceal system and anatomy unfavorable to stenting. The patient’s symptoms were unresponsive to conservative management. Reconstruction of the right collecting system was unsuccessful and a simple nephrectomy was performed, which led to complete resolution of his symptoms.

Renal artery dissection causing renal infarction in otherwise healthy men

1997 ◽  
Vol 30 (6) ◽  
pp. 851-855 ◽  
Author(s):  
Amir Alamir ◽  
Donald F. Middendorf ◽  
Peter Baker ◽  
N.S. Nahman ◽  
Arthur B. Fontaine ◽  
...  
Keyword(s):  
Renal Artery ◽  
Artery Dissection ◽  
Renal Infarction ◽  
Healthy Men
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