Renal vein thrombosis

Case contributed by Ahmed Abdrabou

Presentation

Left loin pain and dysuria. The patient underwent ultrasonography which revealed enlarged hypoechoic left kidney.

Patient Data

Age: 35 years
Gender: Female
ct

The left kidney is enlarged and hypodense with persistent enhancement of its cortex while the parenchyma is not enhanced at the arterial or venous phases. The left renal vein is dilated and shows no evidence of contrast filling at the venous phase.

The IVC and right renal vein are well enhanced with contrast. Moreover, there are few collateral vessels seen at the lower pole of the kidney as well as a smudging of perirenal fat.

Nevertheless, there is a subsegment VII hepatic focal lesion with nodular peripheral enhancement and centripetal filling denoting hemangioma.

Case Discussion

The patient had anti-phospholipid antibody syndrome which results in hypercoagulability of her blood and development of renal vein thrombosis. Doppler study revealed a triphasic wave pattern of the left renal artery (reversal of diastolic flow).

The hepatic lesion is typical for hepatic hemangioma.

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