Presentation
Severe hypotension requiring epinephrine/norepinephrine infusion
Patient Data
Age: 65 years
Gender: Male
From the case:
Spotted nephrograms - severe hypotension
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Alternating dense nephrograms with wedge-shaped non-enhancement presumably due to vasoconstriction.
Case Discussion
Differential diagnosis for bilateral spotted nephrograms is bilateral pyelonephritis, tubular obstruction (esp. proteinaceous), ADPCKD and severe hypotension. Multiple emboli should also be considered.
Unilateral striation differential includes pyleonepritis, high grade ureteric obstruction, renal vein thrombosis and contusion.
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