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Spontaneous renal artery dissection

Case contributed by Chris Newman
Diagnosis almost certain

Presentation

Severe right flank pain.

Patient Data

Age: 40 years
Gender: Male
  • duplicate right renal artery
  • hypoenhancement of the right kidney upper pole with perinephric inflammatory fat stranding in keeping with an upper pole infarct
  • dissection flap demonstrated within the larger right renal artery (origin more inferior), which supplies the upper pole of the right kidney
  • no vessel wall abnormality identified elsewhere to indicate a connective tissue disorder

Case Discussion

This is a case of a spontaneous renal artery dissection of a duplicated right renal artery with an associated upper pole renal infarct.

Spontaneous renal artery dissections are rare with only a few hundred reported cases in the literature. 

The patient was followed up by the vascular unit and urology and was not found to have any risk factors for dissection (i.e. trauma, recent catheterization, connective tissue disorders, fibromuscular dysplasia).

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