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Renal artery stenosis

Case contributed by Alexandra Stanislavsky
Diagnosis almost certain


Hypertensive crisis.

Patient Data

Age: 70 years
Gender: Female

Multiphase CT of the renal tract demonstrates an atrophic right kidney with a delayed nephrogram, with only the tip of the upper pole enhancing vividly.  In contrast, the left kidney is normal in size, and enhances normally.

There is a proximal occlusion of the right renal artery, and the residual arterial supply to the right kidney is derived from small collateral branches. Background atheromatous change is present in the abdominal aorta.

Case Discussion

Findings are consistent with longstanding right renal artery severe stenosis/occlusion.

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