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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.
Competing interests: None.
Patient consent: Obtained.
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