Presentation
Abdominal pain
Patient Data
Two low-attenuation cortical defects in the upper pole of the right kidney. The larger defect has a few areas of faint internal enhancement and thin capsular enhancement. There is atherosclerosis and plaque in the right renal artery, although detailed comments cannot be made due to a lack of angiographic images.
The left common iliac artery is occluded. Partially calcified right adrenal nodule, possibly post-traumatic.
Case Discussion
Acute renal infarction with thin, rim capsular enhancement. This can be helpful to distinguish from acute pyelonephritis, although infarct should be strongly suspected given the other vasculopathic findings (left common iliac occlusion).
Capsular blood supply is supplied by early branches of the renal artery and can remain patent in the setting of distal occlusion, as in this case.
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