Spotted nephrograms - severe hypotension

Case contributed by Dr Chris O'Donnell


Severe hypotension requiring adrenaline/noradrenaline infusion

Patient Data

Age: 65
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: 2nd Apr 2018
System: Urogenital
Inclusion in quiz mode: Included

Updating… Please wait.

Alert accept

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

Alert accept Thank you for updating your details.