Transection of renal artery
This 35 year old female was transferred to hospital after a motor vehicle accident, where she sustained multiple injuries. A CT angiogram was performed.
CT Angiogram - Abdomen and Pelvis
Loading Stack -
0 images remaining
- Left kidney devascularisation, secondary to transection of the left renal artery
- Active bleeding in the left anterior pararenal space
- Splenic injury
- L2 vertebral fracture involving anterior and middle columns.
Renal artery injury (RAI) is an uncommon occurrence, occurring in 2.5-4% of traumatic renal injuries.
Management for renal artery injury is controversial - this is due to its relatively rare nature. There are three main options in RAI 1:
- nephrectomy" only in well patients with two kidneys
- vascular repair
- conservative monitoring: can be complicated by renovascular hypertension 2
In this axial series, note how the left kidney is hypodense compared to the contralateral side. Furthermore, there appears to be homogeneous fluid sitting posteriorly to the left kidney. This represents old blood.
- 1. Elliott SP, Olweny EO, McAninch JW. Renal arterial injuries: a single center analysis of management strategies and outcomes. J. Urol. 2007;178 (6): 2451-5. doi:10.1016/j.juro.2007.08.002 - Pubmed citation
- 2. Bruce LM, Croce MA, Santaniello JM et-al. Blunt renal artery injury: incidence, diagnosis, and management. Am Surg. 2001;67 (6): 550-4. Pubmed citation