Presentation
Known hypertension and diabetes, presented with right flank pain 3 days before admission.
Patient Data
Nonenhanced CT shows a hyperdense blood clot within the right renal artery and the right kidney with perinephric stranding.
Contrast-enhanced CT shows the hypodense blood clot within the lumen of the right renal artery and patchy enhancement of the right kidney with cortical rim sign.
Additional findings:
- calcified atherosclerosis plaques located at proximal of both left and right renal artery
- simple cyst located at the lower pole of the left kidney
The hyperdense blood clot within the lumen of the right renal artery in the non-enhanced phase.
The hypodense blood clot within the lumen of the right renal artery in the contrast-enhanced phase.
Cortical rim sign with the thin, viable rim of subcapsular cortex seen on contrast-enhanced phase.
Case Discussion
This case illustrates typical features of acute renal arterial occlusion.
The patient has some risk factor of renal artery occlusions such as atherosclerosis and atrial fibrillation which are confirmed on ECG. She presented with continuous right flank pain.
CT shows an occluding blood clot in the right renal artery, the patchy enhancement of the right kidney, and cortical rim sign.