IMAGES IN EMERGENCY MEDICINE
Spontaneous renal artery dissection
Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK
Correspondence to:
T L Luk, Basingstoke and North Hampshire NHS Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, UK; tll@lineone.net
Accepted 29 October 2007
| The first 100% of the full text of this article appears below. |
A normotensive 42-year-old man presented to the emergency department with sudden onset of severe left flank pain and vomiting. x Rays, blood tests and urinalysis were normal. The pain persisted despite strong analgesia. The diagnosis at this stage was unclear, and as a result he went on to have a computed tomography scan of the abdomen. This showed that the upper half of the left kidney was ischaemic, the appearance suggesting an infarction (fig 1). A subsequent renal arteriogram revealed a dissection in the mid-segment of the left main renal artery. This was treated successfully with balloon angioplasty supplemented by a 6 mm self-expanding renal stent. Spontaneous renal artery dissection is a rare condition especially in a normotensive patient. Early diagnosis and treatment are essential to preserve renal function.
Figure 1 Computed tomography scan of abdomen showing ischaemia of left kidney.
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Competing interests: None.
Patient consent: Obtained.
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