Idiopathic Renal Infarct as a Rare Cause of Acute Abdominal Pain: A Case Report and Review of Literature

Abstract

Renal infarction is a very rare disease. Due to the non-specific clinical presentation, diagnosis is often missed or delayed. As the result, a prolonged period of ischemia and irreversible renal damage is common. The broad availability of high-quality computed tomography (CT) imaging has made it possible to identify the cases early and initiate prompt treatment. We report a case of renal infarction that presented with acute abdomen. A 56-year-old man with the medical history of hypertension and diabetes mellitus presented to emergency department with a complaint of sudden onset of severe right lower abdominal pain for 1 day. CT scan of abdomen with contrast showed the striated appearance of the right kidney with hypoperfusion and wedge-shaped hypodensities throughout the kidney. After an extensive workup, no apparent cause of renal infarct was found. Due to the absence of underlying cause of atrial fibrillation or hypercoagulable disorder, no anticoagulation was started and he was discharged home on aspirin. Although the incidence of renal infarction is uncommon, it should always be suspected in the patient presenting with flank pain with nausea, vomiting, and fever, especially in presence of risk factor like atrial fibrillation and elevation of lactose dehydrogenase (LDH) with normal or mildly elevated aminotransferases. Early diagnosis and management of renal infarction is important to prevent a prolonged period of ischemia and irreversible damage.




World J Nephrol Urol. 2018;7(2):53-55
doi: https://doi.org/10.14740/wjnu338e