Missed our latest free live-stream? Catch up now on our Procedure Tips (Chris Nicholas) and Right Lower Quadrant Pain (Matt Morgan)

Spotted nephrograms - severe hypotension

Case contributed by Dr Chris O'Donnell


Severe hypotension requiring epinephrine/norepinephrine infusion

Patient Data

Age: 65 years
Gender: Male

CT to look for causes of sepsis or blood loss

Alternating dense nephrograms with wedge-shaped non-enhancement presumably due to vasoconstriction.

Case Discussion

Differential diagnosis for bilateral spotted nephrograms is bilateral pyelonephritis, tubular obstruction (esp. proteinaceous), ADPCKD and severe hypotension.  Multiple emboli should also be considered. 

Unilateral striation differential includes pyleonepritis, high grade ureteric obstruction, renal vein thrombosis and contusion.

PlayAdd to Share

Case information

rID: 20301
Published: 11th Nov 2012
Last edited: 24th Sep 2019
System: Urogenital
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.