Transection of renal artery

Case contributed by Dr Dayu Gai

Presentation

This 35 year old female was transferred to hospital after a motor vehicle accident, where she sustained multiple injuries. A CT angiogram was performed.

Patient Data

Age: 35 years
Gender: Female

CT Angiogram - Abdomen and Pelvis

Modality: CT

Conclusion:

  • 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.

Case Discussion

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.

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Case Information

rID: 30514
Case created: 16th Aug 2014
Last edited: 24th Nov 2015
Inclusion in quiz mode: Included

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