Acute renal infarction

Case contributed by Michael P Hartung

Presentation

Left flank pain.

Patient Data

Age: 75 years
Gender: Male
ct

Absent enhancement within the majority of the left kidney with a few areas of preserved but diminished perfusion. Thrombus filling the left renal artery near the origin. Small amount of perinephric fluid/edema. 

Abdominal aortic aneurysm with prominent calcified and noncalcified plaque. Occlusion of the superior mesenteric artery at its origin with reconstitution, likely via small pancreaticoduodenal arcade collaterals supplied by the celiac/common hepatic artery. 

Case Discussion

Occlusion of the left renal artery resulting in acute infarction in this vasculopathic patient, with absent enhancement of the majority of the left kidney. A few areas of enhancement in the left kidney may be due to a tiny amount of flow preserved in the renal artery. 

Note is made of the common collateral pathway following SMA occlusion, which is likely reconstituted by the pancreaticoduodenal arcade from the celiac artery.

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